Method of treating cancer using immunostimulatory oligonucleotides

ABSTRACT

Nucleic acid sequences containing unmethylated CpG dinucleotides that modulate an immune response including stimulating a Th1 pattern of immune activation, cytokine production, NK lytic activity, and B cell proliferation are disclosed. The sequences are also useful a synthetic adjuvant.

RELATED APPLICATION

This application is a divisional of U.S. Ser. No. 08/960,774, filed Oct.30, 1997, now issued as U.S. Pat. No. 6,239,116B1 on May 29, 2001, whichis a continuation-in-part of U.S. Ser. No. 08/738,652, filed Oct. 30,1996, which is now issued as U.S. Pat. No. 6,207,646B1 on Mar. 27, 2001,which is a continuation-in-part of U.S. patent application Ser. No.08/386,063, filed Feb. 7, 1995 now issued as U.S. Pat. No. 6,194,388B1on Feb. 27, 2001, which is a continuation-in-part of U.S. patentapplication Ser. No. 08/276,358, filed Jul. 15, 1994 which is nowabandoned, each of which are incorporated herein by reference in theirentirety.

GOVERNMENT

The work resulting in this invention was supported in part by NationalInstitute of Health Grant No. R29-AR42556-01. The U.S. Government mayhave rights in the invention.

FIELD OF THE INVENTION

The present invention relates generally to oligonucleotides and morespecifically to oligonucleotides which have a sequence including atleast one unmethylated CpG dinucleotide which are immunostimulatory.

BACKGROUND OF THE INVENTION

In the 1970s, several investigators reported the binding of highmolecular weight DNA to cell membranes (Lerner, R. A., et al. 1971.“Membrane-associated DNA in the cytoplasm of diploid human lymphocytes.”Proc. Natl. Acad. Sci. USA 68:1212; Agrawal, S. K., R. W. Wagner, P. K.McAllister, and B. Rosenberg. 1975. “Cell-surface-associated nucleicacid in tumorigenic cells made visible with platinum-pyrimidinecomplexes by electron microscopy.” Proc. Natl. Acad. Sci. USA 72:928).In 1985, Bennett et al. presented the first evidence that DNA binding tolymphocytes is similar to a ligand receptor interaction: binding issaturable, competitive, and leads to DNA endocytosis and degradationinto oligonucleotides (Bennett, R. M., G. T. Gabor, and M. M. Merritt,1985. “J. Clin. Invest. 76:2182). Like DNA, oligodeoxyribonucleotides(ODNs) are able to enter cells in a saturable, sequence independent, andtemperature and energy dependent fashion (reviewed in Jaroszewski, J.W., and J. S. Cohen. 1991. “Cellular uptake of antisenseoligodeoxynucleotides.” Advanced Drug Deliver Reviews 6:235; Akhtar, S.,Y. Shoji, and R. L. Juliano. 1992. “Pharmaceutical aspects of thebiological stability and membrane transport characteristics of antisenseoligonucleotides.” In: Gene Regulation: Biology of Antisense RNA andDNA. R. P. Erickson, and J. G. Izant, eds. Raven Press, Ltd. New York,pp. 133; and Zhao, Q., T. Waldschmidt, E. Fisher, C. J. Herrera, and A.M. Krieg. 1994. “Stage specific oligonucleotide uptake in murine bonemarrow B cell precursors.” Blood 84:3660). No receptor for DNA or ODNuptake has yet been cloned, and it is not yet clear whether ODN bindingand cell uptake occurs through the same or a different mechanism fromthat of high molecular weight DNA.

Lymphocyte ODN uptake has been shown to be regulated by cell activation.Spleen cells stimulated with the B cell mitogen LPS had dramaticallyenhanced ODN uptake in the B cell population, while spleen cells treatedwith the T cell mitogen Con A showed enhanced ODN uptake by T but not Bcells (Krieg, A. M., F. Gmelig-Meyling, M. F. Gourley, W. J. Kisch, L.A. Chrisey, and A. D. Steinberg. 1991. “Uptake ofoligodeoxyribonucleotides by lymphoid cells is heterogeneous andinducible.” Antisense Research and Development 1:161).

Several polynucleotides have been extensively evaluated as biologicalresponse modifiers. Perhaps the best example is poly (I,C) which is apotent inducer of IFN production as well as macrophage activator andinducer of NK activity (Talmadge, J. E., J. Adams, H. Phillips, M.Collins, B. Lenz, M. Schneider, E. Schlick, R. Ruffmann, R. H. Wiltrout,and M. A. Chirigos. 1985. “Immunomodulatory effects in mice ofpolyinosinic-polycytidylic acid complexed with poly-L-lysine andcarboxymethylcellulose.” Cancer Res. 45:1058; Wiltrout, R. H., R. R.Salup, T. A. Twilley, and J. E. Talmadge. 1985. “Immunomodulation ofnatural killer activity by polyribonucleotides.” J. Biol. Respn. Mod.4:512; Krown, S. E. 1986. “Interferons and interferon inducers in cancertreatment.” Sem. Oncol. 13:207; and Ewel, C. H., S. J. Urba, W. C. Kopp,J. W. Smith II, R. G. Steis, J. L. Rossio, D. L. Longo, M. J. Jones, W.G. Alvord, C. M. Pinsky, J. M. Beveridge, K. L. McNitt, and S. P.Creekmore. 1992. “Polyinosinic-polycytidylic acid complexed withpoly-L-lysine and carboxymethylcellulose in combination withinterleukin-2 in patients with cancer: clinical and immunologicaleffects.” Canc. Res. 52:3005). It appears that this murine NK activationmay be due solely to induction of IFN-p secretion (Ishikawa, R., and C.A. Biron. 1993. “IFN inducation and associated changes in splenicleukocyte distribution”. J. Immunol. 150:3713). This activation wasspecific for the robose sugar since deoxyribose was ineffective. Itspotent in vitro antitumor activity led to several clinical trials usingpoly (I,C) complexed with poly-L-lysine and carboxymethylcellulose (toreduce degradation by RNAse) Talmadge, J. E., et al., 1985. cited supra;Wiltrout, R. H., et al, 1985. cited supra); Krown, S. E., 1986. citedsupra); and Ewel, C. H., et al., 1992. cited supra). Unfortunately,toxic side effects have thus far prevented poly (I,C) from becoming auseful therapeutic agent.

Guanine ribonucleotides substituted at the C8 position with either abromine or a thiol group are B cell mitogens and may replace “B celldifferentiation factors” (Feldbush, T. L., and Z. K., Ballas. 1985.“Lymphokine-like activity of 8-mercaptoguanosine: induction of T and Bcell differentiation.” J. Immunol. 134:3204; and Goodman, M. G. 1986.“Mechanism of synergy between T cell signals and C8-substituted guaninenucleosides in humoral immunity: B lymphotropic cytokines induceresponsiveness to 8-mercaptoguanosine.” J. Immunol. 136:3335).8-mercaptoguanosine and 8-bromoguanosine also can substitute for thecytokine requirement for the generation of MHC restricted CTL (Feldbush,T. L., 1985. cited supra), augment murine NK activity (Koo, G. C., M. E.Jewell, C. L. Manyak, N. H. Sigal, and L. S. Wicker. 1988. “Activationof murine natural killer cells and macrophages by 8-bromoguanosine.” J.Immunol. 140:3249), and synergize with IL-2 in inducing murine LAKgeneration (Thompson, R. A., and Z. K. Ballas. 1990.“Lymphokine-activated killer (LAK) cells. V. 8-Mercaptoguanosine as anIL-2-sparing agent in LAK generation.” J. Immunol. 145:3524). The NK andLAK augmenting activities of these C8-substituted guanosines appear tobe due to their induction of IFN (Thompson, R. A., et al. 1990. citedsupra0. Recently, a 5′ triphosphorylated thymidine produced by amycobacterium was found to be mitogenic for a subset of human γδ T cells(Constant, P., F. Davodeau, M.-A. Peyrat, Y. Poquet, G. Puzo, M.Bonneville, and J.-J. Fournie. 1994. “Stimulation of human γδ T cells bynonpeptidic mycobacterial ligands.” Science 264:267). This reportindicated the possibility that the immune system may have evolved waysto preferentially respond to microbial nucleic acids.

Several observations suggest that certain DNA structures may also havethe potential to activate lymphocytes. For example, Bell et al. reportedthat nucleosomal protein-DNA complexes (but not naked DNA) in spleencell supernatants caused B cell proliferation and immunoglobulinsecretion (Bell, D. A., B. Morrison, and P. VandenBygaart. 1990.“Immunogenic DNA-related factors.” J. Clin. Invest. 85:1487). In othercases, naked DNA has been reported to have immune effects. For example,Messina et al. have recently reported that 260 to 800 bp fragments ofpoly (dG).(dC) and poly (dG.dC) were mitogenic for B cells (Messina, J.P., G. S. Gilkeson, and D. S. Piesetsky. 1993. “The influence of DNAstructure on the in vitro stimulation of murine lymphocytes by naturaland synthetic polynucleotide antigens.” Cell. Immunol. 147:148).Tokunaga, et al. have reported that dGdC induces γ-IFN and NK activity(Tokunaga, S. Yamamoto, and K. Nama. 1988. “A synthetic single-strandedDNA, poly(dG, dC), induces interferon-α/b and -g, augments naturalkiller activity, and suppresses tumor growth.” Jpn. J. Cancer Res.79:682). Aside from such artificial homopolymer sequences, Pisetsky etal. reported that pure mammalian DNA has no detectable immune effects,but that DNA from certain bacteria induces B cell activation andimmunoglobulin secretion (Messina, J. P., G. S. Gilkeson, and D. S.Pisetsky. 1991. “Stimulation of in vitro murine lymphocyte proliferationby bacterial DNA.” J. Immunol. 147:1759). Assuming that these data didnot result from some unusual contaminant, these studies suggested that aparticular structure or other characteristic of bacterial DNA renders itcapable of triggering B cell activation. Investigations of mycobacterialDNA sequences have demonstrated that ODN which contain certainpalindrome sequences can activate NK cells (Yamamoto, S., T. Yamamoto,T. Kataoka, E. Kuramoto, O. Yano, and T. Tokunaga. 1992. “Uniquepalindromic sequences in synthetic oligonucleotides are required toinduce INF and augment INF-mediated natural killer activity.” J.Immunol. 148:4072Kuramoto, E., O. Yano, Y. Kimura, M. Baba, T.Makino, S.Yamamoto, T. Yamamoto, T. Kataoka, and T. Tokunaga. 1992.“Oligonucleotide sequences required for natural killer cell activation.”Jpn. J. Cancer Res. 83:1128).

Several phosphorothioate modified ODN have been reported to induce invitro or in vivo B cell stimulation (Tanaka, T., C. C. Chu, and W. E.Paul. 1992. “An antisense oligonucleotide complementary to a sequence inIg2b increases g2b germline transcripts, stimulates B cell DNAsynthesis, and inhibits immunoglobulin secretion.” J. Exp. Med. 175:597;McIntyre, K. W., K. Lombard-Gillooly, J. R. Perez, C. Kunsch, U. M.Sarmiento, J. D. Larigan, K. T. Landreth, and R. Narayanan. 1993. “Asense phosphorothioate oligonucleotide directed to the initiation codonof transcription factor NF-κB T65 causes sequence-specific immunestimulation.” Antisense Res. Develop. 3:309; and Pisetsky, D. S., and C.F. Reich. 1993. “Stimulation of murine lymphocyte proliferation by aphosphorothioate oligonucleotide with antisense activity for herpessimplex virus.” Life Sciences 54:101). These reports do not suggest acommon structural motif or sequence element in these ODN that mightexplain their effects.

The cAMP response element binding protein (CREB) and activatingtranscription factor (ATF) or CREB/ATF family of transcription factorsis a ubiquitously expressed class of transcription factors of which 11members have so far been cloned (reviewed on de Groot, R. P., and P.Sassone-Corsi: “Hormonal control of gene expression: Multiplicity andversatility of cyclic adenosine 3′,5′-monophosphate-responsive nuclearregulators.” Mol. Endocrin. 7:145, 1993; Lee, K. A. W., and N. Masson:“Transcriptional regulation by CREB and its relatives.” Biochim.Biophys. Acta 1174:221, 1993). They all belong to the basicregion/leucine zipper (bZip) class of proteins. All cells appear toexpress one or more CREB/ATF proteins, but the members expressed and theregulation of mRNA splicing appear to be tissue-specific. Differentialsplicing of activation domains can determine whether a particularCREB/ATF protein will be a transcriptional inhibitor or activator. ManyCREB/ATF proteins activate viral transcription, but some splicingvariants which lack the activation domain are inhibitory. CREB/ATFproteins can bind DNA as homo- or hetero-dimers through the cAMPresponse element, the CRE, the consensus form of which is theunmethylated sequence TGACGTC (SEQ. ID. No. 103) (binding is abolishedif the CpG is methylated) (Iguchi-Ariga, S. M. M., and W. Schaffner:“CpG methylation of the cAMP-responsive enhancer/promoter sequenceTGACGTCA (SEQ. ID. No.104) abolishes specific factor binding as well astranscriptional activation.” Genese & Develop. 3:612, 1989.

The transcriptional activity of the CRE is increased during B cellactivation (Xie. H., T. C. Chiles, and T. L. Rothstein: “Induction ofCREB activity via the surface Ig receptor of B cells.” J. Immunol.151:880, 1993). CREB/ATF proteins appear to regulate the expression ofmultiple genes through the CRE including immunologically important genessuch as fos, jun B, Rb-1, IL-6, IL-1 (Tsukada, J., K. Saito, W. R.Waterman, A. C. Webb, and P. E. Auron: “Transcription factors NF-IL6 andCREB recognize a common essential site in the human prointerleukin 1gene.” Mol. Cell. Biol. 14:7285, 1994; Gray, G. D., O. M. Hernandez, D.Hebel, M. Root, J. M. Pow-Sang, and E. Wickstrom: “Antisense DNAinhibition of tumor growth induced by c-Ha-ras oncogene in nude mice.”Cancer Res. 53:577, 1993), IFN- (Du, W., and T. Maniatis: “An ATF/CREBbinding site protein is required for virus induction of the humaninterferon B gene.” Proc. Natl. Acad. Sci. USA 89:2150, 1992), TGF-1(Asiedu, C. K., L. Scott, R. K. Assoian, M. Ehrlich: “Binding ofAP-1/CREB proteins and of MDBP to contiguous sites downstream of thehuman TGF-B1 gene.” Biochim. Biophys. Acta 1219:55, 1994), TGF-2, classII MHC (Cox, P. M., and C. R. Goding: “An ATF/CREB binding motif isrequired for aberrant constitutive expression of the MHC class II Drapromoter and activation by SV40 T-antigen.” Nuc. Acids Res. 20:4881,1992), E-selectin, GM-CSF, CD-8, the germline Ig constant region gene,the TCR V gene, and the proliferating cell nuclear antigen (Huang, D.,P. M. Shipman-Appasamy, D. J. Orten, S. H. Hinrichs, and M. B.Prystowsky: “Promoter activity of the proliferating-cell nuclear antigengene is associated with inducible CRE-binding proteins in interleukin2-stimulated T lymphocytes.” Mol. Cell. Biol. 14:4233, 1994). Inaddition to activation through the cAMP pathway, CREB can also mediatetranscriptional responses to changes in intracellular Ca⁺⁺ concentration(Sheng, M., G. McFadden, and M. E. Greenberg: “Membrane depolarizationand calcium induce c-fos transcription via phosphorylation oftranscription factor CREB.” Neuron 4:571, 1990).

The role of protein-protein interactions in transcriptional activationby CREB/ATF proteins appears to be extremely important. There areseveral published studies reporting direct or indirect interactionsbetween NFKB proteins and CREB/ATF proteins (Whitley, et al., (1994)Mol. & Cell. Biol. 14:6464; Cogswell, et al., (1994) J. Immun. 153:712;Hines, et al, (1993) Oncogene 8:3189; and Du, et al., (1993) Cell74:887. Activation of CREB through the cyclic AMP pathway requiresprotein kinase A (PKA), which phosphorylates CREB³⁴¹ on ser¹³³ andallows it to bind to a recently cloned protein, CBP (Kwok, R. P. S., J.R. Lundblad, J. C. Chrivia, J. P. Richards, H. P. Bachinger, R. G.Brennan, S. G. E. Roberts, M. R. Green, and R. H. Goodman: “Nuclearprotein CBP is a coactivator for the transcription factor CREB.” Nature370:223, 1994; Arias, J., A. S. Alberts, P. Brindle, F. X. Claret, T.Smea, M. Karin, J. Feramisco, and M. Montminy: “Activation of cAMP andmitogen responsive genes relies on a common nuclear factor.” Nature370:226, 1994). CBP in turn interacts with the basal transcriptionfactor TFIIB causing increased transcription. CREB also has beenreported to interact with dTAFII 110, a TATA binding protein-associatedfactor whose binding may regulate transcription (Ferreri, K., G. Gill,and M. Montminy: “The cAMP-regulated transcription factor CREB interactswith a component of the TFIID complex.” Proc. Natl. Acad. Sci. USA91:1210, 1994). In addition to these interactions, CREB/ATF proteins canspecifically bind multiple other nuclear factors (Hoeffler, J. P., J. W.Lustbadfer, and C.-Y. Chen: “Identification of multiple nuclear factorsthat interact with cyclic adenosine 3′,5′-monophosphate responseelement-binding protein and activating transcription factor-2 byprotein-protein interactions.” Mol. Endocrinol. 5:256, 1991) but thebiologic significance of most of these interactions is unknown. CREB isnormally thought to bind DNA either as a homodimer or as a heterodimerwith several other proteins. Surprisingly, CREB monomers constitutivelyactivate transcription (Krajewski, W., and K. A. W. Lee: “A monomericderivative of the cellular transcription factor CREB functions as aconstitutive activator.” Mol. Cell. Biol. 14:7204, 1994).

Aside from their critical role in regulating cellular transcription, ithas recently been shown that CREB/ATF proteins are subverted by someinfectious viruses and retroviruses, which require them for viralreplication. For example, the cytomegalovirus immediate early promoter,one of the strongest known mammalian promoters, contains eleven copiesof the CRE which are essential for promoter function (Chang, Y.-N., S.Crawford, J. Stall, D. R. Rawlins, K.-T. Jeang, and G. S. Hayward: “Thepalindromic series I repeats in the simian cytomegalovirus majorimmediate-early promoter behave as both strong basal enhancers andcyclic AMP response elements.” J. Virol. 64:264, 1990). At least some ofthe transcriptional activating effects of the adenovirus E1A protein,which induces many promoters, are due to its binding to the DNA bindingdomain of the CREB/ATF protein, ATF-2, which mediates E1A inducibletranscription activation (Liu, F., and M. R. Green: “Promoter targetingby adenovirus E1A through interaction with different cellularDNA-binding domains.” Nature 368:520, 1994). It has also been suggestedthat E1A binds to the CREB-binding protein, CBP (Arany, Z., W. R.Sellers, D. M. Livingston, and R. Eckner: “E1A-associated p300 andCREB-associated CBP belong to a conserved family of coactivators.” Cell77:799, 1994). Human T lymphotropic virus-I (HTLV-1), the retroviruswhich causes human T cell leukemia and tropical spastic paresis, alsorequires CREB/ATF proteins for replication. In this case, the retrovirusproduces a protein, Tax, which binds to CREB/ATF proteins and redirectsthem from their normal cellular binding sites to different DNA sequences(flanked by G- and G-rich sequences) present within the HTLVtranscriptional enhancer (Paca-Uccaralertkun, S., L.-J. Zhao, N. Adya,J. V. Cross, B. R. Cullen, I. M. Boros, and C.-Z. Giam: “In vitroselection of DNA elements highly responsive to the human T-celllymphotropic virus type I transcriptional activator, Tax.” Mol. Cell.Biol. 14:456, 1994; Adya, N., L.-J. Zhao, W. Huang, I. Boros, and C.-Z.Giam: “Expansion of CREB's DNA recognition specificity by Tax resultsfrom interaction with Ala-Ala-Arg at positions 282-284 near theconserved DNA-binding domain of CREB.” Proc. Natl. Acad. Sci. USA91:5642, 1994).

SUMMARY OF THE INVENTION

The present invention is based on the finding that certain nucleic acidscontaining unmethylated cytosine-guanine (CpG) dinucleotides activatelymphocytes in a subject and redirect a subject's immune response from aTh2 to a Th1 (e.g., by inducing monocytic cells and other cells toproduce Th1 cytokines, including IL-12, IFN-γ and GM-CSF). Based on thisfinding, the invention features, in one aspect, novel immunostimulatorynucleic acid compositions.

In one embodiment, the invention provides an isolated immunostimulatorynucleic acid sequence containing a CpG motif represented by the formula:

5′N₁X₁CGX₂N₂3′

wherein at least one nucleotide separates consecutive CpGs; X₁ isadenine, guanine, or thymine; X₂ is cytosine or thymine; N is anynucleotide and N₁+N₂ is from about 0-26 bases with the proviso that N₁and N₂ do not contain a CCGG quadmer or more than one CCG or CGG trimer;and the nucleic acid sequence is from about 8-30 bases in length.

In another embodiment, the invention provides an isolatedimmunostimulatory nucleic acid sequence contains a CpG motif representedby the formula:

5′N₁X₁X₂CGX₃X₄N₂C′

wherein at least one nucleotide separates consecutive CpGs; X₁X₂ isselected from the group consisting of GpT, GpG, GpA, ApT and ApA; X₃ X₄is selected from the group consisting of TpT or CpT; N is any nucleotideand N₁+N₂ is from about 0-26 bases with the proviso that N₁ and N₂ donot contain a CCGG quadmer or more than one CCG or CGG trimer; and thenucleic acid sequence is from about 8-30 bases in length.

In another embodiment, the invention provides a method of stimulatingimmune activation by administering the nucleic acid sequences of theinvention to a subject, preferably a human. In a preferred embodiment,the immune activation effects predominantly a Th1 pattern of immuneactivation.

In another embodiment, the nucleic acid sequences of the inventionstimulate cytokine production. In particular, cytokines such as IL-6,IL-12, IFN-γ, TNF-α and GM-CSF are produced via stimulation of theimmune system using the nucleic acid sequences described herein. Inanother aspect, the nucleic acid sequences of the invention stimulatethe lytic activity of natural killer cells (NK) and the proliferation ofB cells.

In another embodiment, the nucleic acid sequences of the invention areuseful as an artificial adjuvant for use during antibody generation in amammal such as a mouse or a human.

In another embodiment, autoimmune disorders are treated by inhibiting asubject's response to CpG mediated leukocyte activation. The inventionprovides administration of inhibitors of endosomal acidification such asbafilomycin a, chloroquine, and monensin to ameliorate autoimmunedisorders. In particular, systemic lupus erythematosus is treated inthis manner.

The nucleic acid sequences of the invention can also be used to treat,prevent or ameliorate other disorders (e.g., a tumor or cancer or aviral, fungal, bacterial or parasitic infection). In addition, thenucleic acid sequences can be administered to stimulate a subject'sresponse to a vaccine. Furthermore, by redirecting a subject's immuneresponse from Th2 to Th1, the claimed nucleic acid sequences can be usedto treat or prevent an asthmatic disorder. In addition, the claimednucleic acid molecules can be administered to a subject in conjunctionwith a particular allergen as a type of desensitization therapy to treator prevent the occurrence of an allergic reaction associated with anasthmatic disorder.

Further, the ability of the nucleic acid sequences of the inventiondescribed herein to induce leukemic cells to enter the cell cyclesupports their use in treating leukemia by increasing the sensitivity ofchronic leukemia cells followed by conventional ablative chemotherapy,or by combining the nucleic acid sequences with other immunotherapies.

Other features and advantages of the invention will become more apparentfrom the following detailed description and claims.

BRIEF DESCRIPTION OF THE FIGURES

FIGS. 1A-C are graphs plotting dose-dependent IL-6 production inresponse to various DNA sequences in T cell depleted spleen cellcultures.

FIG. 1A. E. coli () and calf thymus DNA (▪) sequences and LPS (at 10×the concentration of E. coli and calf thymus DNA) (♦).

FIG. 1B. Control phosphodiester oligodeoxynucleotide (ODN) 5′ATGGAAGGTCCAGTGTTCTC 3′ (SEQ ID NO:1 14) (▪) and two phosphodiester CpGODN 5′ ATCGACCTACGTGCGTTCTC 3′ (SEQ ID NO:2) (♦) and 5′TCCATAACGTTCCTGATGCT 3′ (SEQ ID NO:3) ().

FIG. 1C. Control phosphorothioate ODN 5′ GCTAGATGTTAGCGT 3′ (SEQ IDNO:4) (▪) and two phosphorothioate CpG ODN 5′ GAGAACGTCGACCTTCGAT 3′(SEQ ID NO: 5) (▪) and 5′ GCATGACGTTGAGCT 3′ (SEQ ID NO:6) (). Datapresent the mean±standard deviation of triplicates.

FIG. 2 is a graph plotting IL-6 production induced by CpG DNA in vivo asdetermined 1-8 hrs after injection. Data represent the mean forduplicate analyses of sera from two mice. BALB/c mice (two mice/group)were inject iv. with 100 μl of PBS (□) of 200 μg of CpG phosphorothioateODN 5′ TCCATGACGTTCCTGATGCT 3′ (SEQ ID NO:7) (▪) or non-CpGphosphorothioate 5′ TCCATGAGCTTCCTGAGTCT 3′ (SEQ ID NO: 8) (♦).

FIG. 3 is an autoradiograph showing IL-6 mRNA expression as determinedby reverse transcription polymerase chain reaction in liver, spleen, andthymus at various time periods after in vivo stimulation of BALB/c mice(two mice/group) injected iv with 100 μl of PBS, 200 μl of CpGphosphorothioate ODN 5′ TCCATGACGTTCCTGATGCT 3′ (SEQ ID NO: 7) ornon-CpG phosphorothioate ODN 5′ TCCATGAGCTTCCTGAGTCT 3′ (SEQ ID NO: 8).

FIG. 4A is a graph plotting dose-dependent inhibition of CpG-induced IgMproduction by anti-IL-6. Splenic B-cells from DBA/2 mice were stimulatedwith CpG ODN 5′ TCCAAGACGTTCCTGATGCT 3′ (SEQ ID NO:9) in the presence ofthe indicated concentrations of neutralizing anti-IL-6 (♦) or isotypecontrol Ab () and IgM levels in culture supernatants determined byELISA. In the absence of CpG ODN, the anti-IL-6 Ab had no effect on IgMsecretion (▪).

FIG. 4B is a graph plotting the stimulation index of CpG-induced splenicB cells cultured with anti-IL-6 and CpG S—ODN 5′ TCCATGACGTTCCTGATGCT 3′(SEQ ID NO:7) (♦) or anti-IL-6 antibody only (▪). Data present themean±standard deviation of triplicates.

FIG. 5 is a bar graph plotting chloramphenicol acetyltransferase (CAT)activity in WEH1-231 cells transfected with a promoter-less CATconstruct (pCAT), positive control plasmid (RSV), or IL-6 promoter-CATconstruct alone or cultured with CpG 5′ TCCATGACGTTCCTGATGCT 3′ (SEQ IDNO: 7) or non-CpG 5′ TCCATGAGCTTCCTGAGTCT 3′ (SEQ ID NO: 8)phosphorothioate ODN at the indicated concentrations. Data present themean of triplicates.

FIG. 6 is a schematic overview of the immune effects of theimmunostimulatory unmethylated CpG containing nucleic acids, which candirectly activate both B cells and monocytic cells (includingmacrophages and dendritic cells) as shown. The immunostimulatoryoligonucleotides do not directly activate purified NK cells, but renderthem competent to respond to IL-12 with a marked increase in their IFN-γsecretion by NK cells, the immunostimulatory nucleic acids promote a Th1type immune response. No direct activation of proliferation of cytokinesecretion by highly purified T cells has been found. However, theinduction of Th1 cytokine secretion by the immunostimulatoryoligonucleotides promotes the development of a cytotoxic lymphocyteresponse.

FIG. 7 is an autoradiograph showing NFκB mRNA induction in monocytestreated with E. coli (EC) DNA (containing unmethylated CpG motifs),control (CT) DNA (containing no unmethylated CpG motifs) andlipopolysaccharide (LPS) at various measured times, 15 and 30 minutesafter contact.

FIG. 8A shows the results from a flow cytometry study using mouse Bcells with the dihydrorhodamine 123 dye to determine levels of reactiveoxygen species. The dye only sample in Panel A of the figure shows thebackground level of cells positive for the dye at 28.6%. This level ofreactive oxygen species was greatly increased to 80% in the cellstreated for 20 minutes with PMA and ionomycin, a positive control (PanelB). The cells treated with the CpG oligo (TCCATGACGTTCCTGACGTT SEQ IDNO: 10) also showed an increase in the level of reactive oxygen speciessuch that more than 50% of the cells became positive (Panel D). However,cells treated with an oligonucleotide with the identical sequence exceptthat the CpGs were switched (TCCATGAGCTTCCTGAGTCT SEQ ID NO: 8) did notshow this significant increase in the level of reactive oxygen species(Panel E).

FIG. 8B shows the results from a flow cytometry study using mouse Bcells in the presence of chloroquine with the dihydrorhodamine 123 dyeto determine levels of reactive oxygen species. Chloroquine slightlylowers the background level of reactive oxygen species in the cells suchthat the untreated cells in Panel A have only 4.3% that are positive.Chloroquine completely abolishes the induction of reactive oxygenspecies in the cells treated with CpG DNA (Panel B) but does not reducethe level of reactive oxygen species in the cells treated with PMA andionomycin (Panel E).

FIG. 9 is a graph plotting lung lavage cell count over time. The graphshows that when the mice are initially injected with Schistosoma mansonieggs “egg”, which induces a Th2 immune response, and subsequently inhaleSchistosoma mansoni egg antigen “SEA” (open circle), many inflammatorycells are present in the lungs. However, when the mice are initiallygiven CpG oligo (SEQ ID NO: 10) along with egg, the inflammatory cellsin the lung are not increased by subsequent inhalation of SEA (opentriangles).

FIG. 10 is a graph plotting lung lavage eosinophil count over time.Again, the graph shows that when the mice are initially injected withegg and subsequently inhale SEA (open circle), many eosinophils arepresent in the lungs. However, when the mice are initially given CpGoligo (SEQ ID NO: 10) along with egg, the inflammatory cells in the lungare not increased by subsequent inhalation of the SEA (open triangles).

FIG. 11 is a bar graph plotting the effect on the percentage ofmacrophage, lymphocyte, neutrophil and eosinophil cells induced byexposure to saline alone; egg, then SEA; egg and SEQ ID NO: 11, thenSEA; and egg and control oligo (SEQ ID NO: 11), then SEA. When the miceare treated with the control oligo at the time of the initial exposureto the egg, there is little effect on the subsequent influx ofeosinophils into the lungs after inhalation of SEA. Thus, when miceinhale the eggs on days 14 or 21, they develop an acute inflammatoryresponse in the lungs. However, giving a CpG oligo along with the eggsat the time of initial antigen exposure on days 0 and 7 almostcompletely abolishes the increase in eosinophils when the mice inhalethe egg antigen on day 14.

FIG. 12 is a bar graph plotting eosinophil count in response toinjection of various amounts of the protective oligo SEQ ID NO: 10.

FIG. 13 is a graph plotting interleukin 4 (IL-4) production (pg/ml) inmice over time in response to injection of egg, then SEA (open diamond);egg and SEQ ID NO: 10, then SEA (open circle); or saline, then saline(open square). The graph shows that the resultant inflammatory responsecorrelates with the levels of the Th2 cytokine IL-4 in the lung.

FIG. 14 is a bar graph plotting interleukin 12 (IL-12) production(pg/ml) in mice over time in response to injection of saline; egg, thenSEA; or SEQ ID NO. 10 and egg, then SEA. The graph shows thatadministration of an oligonucleotide containing an unmethylated CpGmotif can actually redirect the cytokine response of the lung toproduction of IL-12, indicating a Th1 type of immune response.

FIG. 15 is a bar graph plotting interferon gamma (IFN-γ) production(pg/ml) in mice over time in response to injection of saline; egg, thensaline; or SEQ ID NO: 10 and egg, then SEA. The graph shows thatadministration of an oligonucleotide containing an unmethylated CpGmotif can also redirect the cytokine response of the lung to productionof IFN-g, indicating a Th1 type of immune response.

DETAILED DESCRIPTION OF THE INVENTION

Definitions

As used herein, the following terms and phrases shall have the meaningsset forth below:

An “allergen” refers to a substance that can induce an allergicasthmatic response in a susceptible subject. The list of allergens isenormous and can include pollens, insect venoms, animal dander dust,fungal spores and drugs (e.g, penicillin). Examples of natural, animaland plant allergens include proteins specific to the following genuses:Canine (Canis familiaris); Dermatophagoides (e.g, Dermatophagoidesfarinae); Felis (Felis domesticus); Ambrosia (Ambrosia artemiisfolia;Lolium (e.g., Lolium perenne or Lolium multiflorum), Cryptomeria(Cryptomeria japonica); Alternaria (Alternaria alternata); Alder; Alnus(Alnus gultinosa); Betula (Betula verrucosa); Quercus (quercus alba);Olea (Olea europa); Artemisia (Artemisia vulgaris); Plantago (e.g.,Plantago lanceolata); Parietaria (e.g., Parietaria officinalis orParietaria judaica); Blattella (e.g., Blattella germanica); Apis (e.g.,Apis multiflorum); Cupressus (e.g., Cupressus sempervirens, Cupressusarizonica and Cupressus macrocarpa); Juniperus (e.g, Juniperussabinoides, Juniperus virginiana, Juniperus communis and Juniperusashei); Thuya (e.g., Thuya orientalis), Chamaecyparis (e.g.,Chamaecyparis obtusa); Periplaneta (e.g., Periplaneta americana);Agropyron (e.g, Agropyron repens); Secale (e.g., Secale cereale);Triticum (e.g., Triticum aestivum); Dactylis (e.g., Dactylis glomerata);Festuca (e.g., Festuca elatior); Poa (e.g., Poa pratensis or Poacompressa); Avena (e.g., Avena sativa); Holcus (e.g., Holcus lanatus);Anthoxanthum (e.g., Anthoxanthum odoratum); Arrhenatherum (e.g.,Arrhenatherum elatius), Agrostis (e.g., Agrostis alba); Phleum (e.g,Phleum pratense); Phalaris (e.g, Phalaris arundinacea); Paspalum (e.g,Paspalum notatum); Sorghum (e.g., Sorghum halepensis) and Bromus (e.g,Bromus inermis).

An “allergy” refers to acquired hypersensitivity to a substance(allergen). Allergic conditions include eczema, allergic rhinitis orcoryza, hay fever, bronchial asthma, urticaria (hives) and foodallergies, and other atopic conditions.

“Asthma” refers to a disorder of the respiratory system characterized byinflammation, narrowing of the airways and increased reactivity of theairways to inhaled agents. Asthma is frequently, although notexclusively associated with atopic or allergic symptoms.

An “immune system deficiency” shall mean a disease or disorder in whichthe subject's immune system is not functioning in normal capacity or inwhich it would be useful to boost a subject's immune response forexample to eliminate a tumor or cancer (e.g., tumors of the brain, lung(e.g., small cell and non-small cells), ovary, breast, prostate, colon,as well as other carcinomas and sarcomas) or an infection in a subject.

Examples of infectious virus include: Retroviridae (e.g., humanimmunodeficiency viruses, such as HIV-1, also referred to as HTLV-III,LAV or HTLV-III/LAV, or HIV-III; and other isolates, such as HIV-LP;Picornaviridae (e.g., polio viruses, hepatitis A virus; enteroviruses,human coxsackie viruses, rhinoviruses, echoviruses); Calciviridae (e.g.,strains that cause gastroenteritis); Togaviridae (e.g., equineencephalitis viruses, rubella viruses); Flaviridae (e.g., dengueviruses, encephalitis viruses, yellow fever viruses); Coronaviridae(e.g., coronaviruses); Rhabdoviridae (e.g., vesicular stomatitisviruses, rabies viruses); Filoviridae (e.g, ebola viruses);Paramyxoviridae (e.g., parainfluenza viruses, mumps virus, measlesvirus, respiratory syncytial virus); Orthomyxoviridae (e.g., influenzaviruses); Bungaviridae (e.g, Hantaan viruses, bunga viruses,phleboviruses and Nairo viruses); Arena viridae (hemorrhagic fevervirus); Reoviridae (e.g., reoviruses, orbiviruses and rotaviruses);Birnaviridae; Hepadnaviridae (Hepatitis B virus); Parvoviridae(parvoviruses); Papovaviridae (papilloma viruses, polyoma viruses);Adenoviridae (most adenoviruses); Herperviridae (herpes simplex virus(HSV) 1 and 2, varicella zoster virus, cytomegalovirus (CMV), herpesviruses); Poxviridae (variola virsues, vaccinia viruses, pox viruses);and Iridoviridae (e.g., African swine fever virus); and unclassifiedviruses (e.g., the etiological agents of Spongiform encephalopathies,the agent of delta hepatitides (thought to be a defective satellite ofhepatitis B virus), the agents of non-A, non-B hepatitis (class1—internally transmitted; class 2—parenterally transmitted (i.e.,Hepatitis C); Norwalk and related viruses, and astroviruses).

Examples of infectious bacteria include: Helicobacter pyloris, Boreliaburgdorferi, Legionella pneumophilia, Mycobacteria sps (e.g., M.tuberculosis, M. avium, M. Intracellulare, M. kansaii, M. gordonae),Staphylococcus aureus, Neisseria gonorrhoeae, Neisseria meningitidis,Listeria monocytogenes, Streptococcus pyogenes (Group A Streptococcus),Streptococcus agalactiae (Group B Streptococcus), Streptococcus(viridans group), Streptococcus faecalis, Streptococcus bovis,Streptococcus (anaerobic sps.), Streptococcus pneumoniae, pathogenicCampylobacter sp., Enterococcus sp., Haemophilus influenzae, Bacillusantracis, corynebacterium diphtheriae, corynebacterium sp.,Erysipelothrix rhusiopathiae, Clostridium perfringers, Clostridiumtetani, Enterobacter erogenes, Klebsielia pneuomiae, Pasturellamulticoda, Bacteroides sp., Fusobacterium nucleatum, Sreptobacillusmonitiformis, Treponema pallidium, Treponema pertenue, Leptospira, andActinomeyces israelli.

Examples of infectious fungi include: Cryptococcus neoformans,Histoplasma capsulatum, Coccidioides immitis, Blastomyces dermatitidis,Chlamydia trachomatis, Candida albicans. Other infectious organisms(i.e., protists) include: Plasmodium falciparum and Toxoplasma gondii.

An “immunostimulatory nucleic acid molecule” refers to a nucleic acidmolecule, which contains an unmethylated cytosine, guanine dinucleotidesequence (i.e., “CpG DNA” or DNA containing a cytosine followed byguanosine and linked by a phosphate bond) and stimulates (e.g., has amotogenic effect on, or induces or increases cytokine expression by) avertebrate lymphocyte. An immunostimulatory nucleic acid molecule can bedouble-stranded or single-stranded. Generally, double-stranded moleculesare more stable in vivo, while single-stranded molecules have increasedimmune activity.

In one preferred embodiment, the invention provides an isolatedimmunostimulatory nucleic acid sequence containing a CpG motifrepresented by the formula:

5′N₁X₁CGX₂N₂3′

wherein at least one nucleotide separates consecutive CpGs; X₁ isadenine, guanine, or thymine; X₂ is cytosine or thymine; N is anynucleotide and N₁+N₂ is from about 0-26 bases with the proviso that N₁and N₂ do not contain a CCGG quadmer or more than one CCG or CGG trimer;and the nucleic acid sequence is from about 8-30 bases in length.

In another embodiment the invention provides an isolatedimmunostimulatory nucleic acid sequence contains a CpG motif representedby the formula:

5′N₁X₁X₂CGX₃X₄N₂3′

wherein at least one nucleotide separates consecutive CpGs; X₁X₂ isselected from the group consisting of GpT, GpG, GpA, ApT and ApA; X₃X₄is selected from the group consisting of TpT or CpT; N is any nucleotideand N₁+N₂ is from about 0-26 bases with the proviso that N₁ and N₂ donot contain a CCGG quadmer or more than one CCG or CGG trimer; and thenucleic acid sequence is from about 8-30 bases in length.

Preferably, the immunostimulatory nucleic acid sequences of theinvention include X₁X₂ selected from the group consisting of GpT, GpG,GpA and ApA and X₃X₄ is selected from the group consisting of TpT, CpTand GpT (see for example, Table 5). For facilitating uptake into cells,CpG containing immunostimulatory nucleic acid molecules are preferablyin the range of 8 to 30 bases in length. However, nucleic acids of anysize (even many kb long) are immunostimulatory if sufficientimmunostimulatory motifs are present, since such larger nucleic acidsare degraded into oligonucleotides inside of cells. Preferred syntheticoligonucleotides do not include a CGG quadmer or more than one CCG orCGG trimer at or near the 5′ and/or 3′ terminals and/or the consensusmitogenic CpG motif is not a palindrome. Prolonged immunostimulation canbe obtained using stabilized oligonucleotides, where the oligonucleotideincorporates a phosphate backbone modification. For example, themodification is a phosphorothioate or phosphorodithioate modification.More particularly, the phosphate backbone modification occurs at the 5′end of the nucleic acid for example, at the first two nucleotides of the5′ end of the nucleic acid. Further, the phosphate backbone modificationmay occur at the 3′ end of the nucleic acid for example, at the lastfive nucleotides of the 3′ end of the nucleic acid.

Preferably the immunostimulatory CpG DNA is in the range of between 8 to30 bases in size when it is an oligonucleotide. Alternatively, CpGdinucleotides can be produced on a large scale in plasmids, which afterbeing administered to a subject are degraded into oligonucleotides.Preferred immunostimulatory nucleic acid molecules (e.g., for use inincreasing the effectiveness of a vaccine or to treat an immune systemdeficiency by stimulating an antibody (i.e., humoral) response in asubject) have a relatively high stimulation index with regard to B cell,monocyte and/or natural killer cell responses (e.g., cytokine,proliferative, lytic or other responses).

The nucleic acid sequences of the invention stimulate cytokineproduction in a subject for example. Cytokines include but are notlimited to IL-6, IL-12, IFN-γ, TNF-α and GM-CSF. Exemplary sequencesinclude: TCCATGTCGCTCCTGATGCT (SEQ ID NO: 37), TCCATGTCGTTCCTGATGCT (SEQID NO: 38), and TCGTCGTTTTGTCGTTTTGTCGTT (SEQ ID NO: 46).

The nucleic acid sequences of the invention are also useful forstimulating natural killer cell (NK) lytic activity in a subject such asa human. Specific, but non-limiting examples of such sequences include:TCGTCGTTGTCGTTGTCGTT (SEQ ID NO: 47), TCGTCGTTTTGTCGTTTTGTCGTT (SEQ IDNO: 46), TCGTCGTTGTCGTTTTGTCGTT (SEQ ID NO: 49), GCGTGCGTTGTCGTTGTCGTT(SEQ ID NO: 56), TGTCGTTTGTCGTTTGTCGTT (SEQ ID NO: 48),TGTCGTTGTCGTTGTCGTT (SEQ ID NO: 50) and TCGTCGTCGTCGTT (SEQ ID NO: 51).

The nucleic acid sequences of the invention are useful for stimulating Bcell proliferation in a subject such as a human. Specific, butnon-limiting examples of such sequences include: TCCTGTCGTTCCTTGTCGTT(SEQ ID NO: 52), TCCTGTCGTTTTTTGTCGTT (SEQ ID NO: 53),TCGTCGCTGTCTGCCCTTCTT (SEQ ID NO: 54), TCGTCGCTGTTGTCGTTTCTT (SEQ ID NO:55), TCGTCGTTTTGTCGTTTTGTCGTT (SEQ ID NO: 46), TCGTCGTTGTCGTTTTGTCGTT(SEQ ID NO: 49) and TGTCGTTGTCGTTGTCGTT (SEQ ID NO: 50).

In another aspect, the nucleic acid sequences of the invention areuseful as an adjuvant for use during antibody production in a mammal.Specific, but non-limiting examples of such sequences include:TCCATGACGTTCCTGACGTT (SEQ ID NO: 10), GTCGTT (SEQ. ID. NO: 57), GTCGCT(SEQ. ID. NO.58), TGTCGCT (SEQ. ID. NO: 101) and TGTCGTT (SEQ. ID. NO:102). Furthermore, the claimed nucleic acid sequences can beadministered to treat or prevent the symptoms of an asthmatic disorderby redirecting a subject's immune response from Th2 to Th 1. Anexemplary sequence includes TCCATGACGTTCCTGACGTT (SEQ ID NO: 10).

The stimulation index of a particular immunostimulatory CpG DNA can betested in various immune cell assays. Preferably, the stimulation indexof the immunostimulatory CpG DNA with regard to B-cell proliferation isat least about 5, preferably at least about 10, more preferably at leastabout 15 and most preferably at least about 20 as determined byincorporation of ³H uridine in a murine B cell culture, which has beencontacted with a 20 μM of ODN for 20 h at 37° C. and has peen pulsedwith 1 μCi of ³H uridine; and harvested and counted 4 h later asdescribed in detail in Example 1. For use in vivo, for example to treatan immune system deficiency by stimulating a cell-mediated (local)immune response in a subject, it is important that the immunostimulatoryCpG DNA be capable of effectively inducing cytokine secretion bymonocytic cells and/or Natural Killer (NK) cell lytic activity.

Preferred immunostimulatory CpG nucleic acids should effect at leastabout 500 pg/ml of TNF-α, 15 pg/ml IFN-γ, 70 pg/ml of GM-CSF 275 pg/mlof IL-6, 200 pg/ml IL-12, depending on the therapeutic indication, asdetermined by the assays described in Example 12. Other preferredimmunostimulatory CpG DNAs should effect at least about 10%, morepreferably at least about 15% and most preferably at least about 20%YAC-1 cell specific lysis or at least about 30, more preferably at leastabout 35 and most preferably at least about 40% 2C11 cell specific lysisas determined by the assay described in detail in Example 4.

A “nucleic acid” or “DNA” means multiple nucleotides (i.e., moleculescomprising a sugar (e.g., ribose or deoxyribose) linked to a phosphategroup and to an exchangeable organic base, which is either a substitutedpyrimidine (e.g., cytosine (C), thymine (T) or uracil (U)) or asubstituted purine (e.g., adenine (A) or guanine (G)). As used herein,the term refers to ribonucleotides as well as oligodeoxyribonucleotides.The term shall also include polynucleotides (i.e., a polynucleotideminus the phosphate) and any other organic base containing polymer.Nucleic acid molecules can be obtained from existing nucleic acidsources (e.g., genomic or cDNA), but are preferably synthetic (e.g.,produced by oligonucleotide synthesis).

A “nucleic acid delivery complex” shall mean a nucleic acid moleculeassociated with (e.g., ionically or covalently bound to; or encapsulatedwithin) a targeting means (e.g., a molecule that results in higheraffinity binding to target cell (e.g., B-cell and natural killer (NK)cell) surfaces and/or increased cellular uptake by target cells).Examples of nucleic acid delivery complexes include nucleic acidsassociated with: a sterol (e.g., a ligand recognized by target cellspecific receptor). Preferred complexes must be sufficiently stable invivo to prevent significant uncoupling prior to internalization by thetarget cell. However, the complex should be cleavable under appropriateconditions within the cell so that the nucleic acid is released in afunctional form.

“Palindromic sequences” shall mean an inverted repeat (i.e., a sequencesuch as ABCDEE′D′C′B′A′ in which A and A′ are bases capable of formingthe usual Watson-Crick base pairs. In vivo, such sequences may formdouble stranded structures.

A “stabilized nucleic acid molecule” shall mean a nucleic acid moleculethat is relatively resistant to in vivo degradation (e.g., via an exo-or endo-nuclease). Stabilization can be a function of length orsecondary structure. Unmethylated CpG containing nucleic acid moleculesthat are tens to hundreds of kbs long are relatively resistant to invivo degradation. For shorter immunostimulatory nucleic acid molecules,secondary structure can stabilize and increase their effect. Forexample, if the 3′ end of a nucleic acid molecule hasself-complementarily to an upstream region, so that it can fold back andform a sort of stem loop structure, then the nucleic acid moleculebecomes stabilized and therefore exhibits more activity.

Preferred stabilized nucleic acid molecules of the instant inventionhave a modified backbone. For use in immune stimulation, especiallypreferred stabilized nucleic acid molecules are phosphorothioate (i.e.,at least one of the phosphate oxygens of the nucleic acid molecules isreplaced by sulfur) or phosphorodithioate modified nucleic acidmolecules. More particularly, the phosphate backbone modification occursat the 5′ end of the nucleic acid for example, at the first twonucleotides of the 5′ end of the nucleic acid. Further, the phosphatebackbone modification may occur at the 3′ end of the nucleic acid forexample, at the last five nucleotides of the 3′ end of the nucleic acid.In addition to stabilizing nucleic acid molecules, as reported furtherherein, phosphorothioate-modified nucleic acid molecules (includingphosphorodithioate-modified) can increase the extent of immunestimulation of the nucleic acid molecule, which contains an unmethylatedCpG dinucleotide as shown herein. International Patent ApplicationPublication Number WO 95/26204 entitled “Immune Stimulation ByPhosphorothioate Oligonucleotide Analogs” also reports on thenon-sequence specific immunostimulatory effect of phosphorothioatemodified oligonucleotides. As reported herein, unmethylated CpGcontaining nucleic acid molecules having a phosphorothioate backbonehave been found to preferentially activate B-cell activity, whileunmethylated CpG containing nucleic acid molecules having aphosphodiester backbone have been found to preferentially activatemonocytic (macrophages, dendritic cells and monocytes) and NK cells.Phosphorothioate CpG oligonucleotides with preferred human motifs arealso strong activators of monocytic and NK cells.

Other stabilized nucleic acid molecules include: nonionic DNA analogs,such as alkyl- and aryl-phosphonates (in which the charged phosphonateoxygen is replaced by an alkyl or aryl group), phosphodiester andalkylphosphotriesters, in which the charged oxygen moiety is alkylated.Nucleic acid molecules which contain a diol, such as tetraethylenglycolor hexaethyleneglycol, at either or both termini have also been shown tobe substantially resistant to nuclease degradation.

A “subject” shall mean a human or vertebrate animal including a dog,cat, horse, cow, pig, sheep, goat, chicken, monkey, rat, and mouse.

As used herein, the term “vector” refers to a nucleic acid moleculecapable of transporting another nucleic acid to which it has beenlinked. Preferred vectors are those capable of autonomous replicationand expression of nucleic acids to which they are linked (e.g., anepisome). Vectors capable of directing the expression of genes to whichthey are operatively linked are referred to herein as “expressionvectors.” In general, expression vectors of utility in recombinant DNAtechniques are often in the form of “plasmids” which refer generally tocircular double stranded DNA loops which, in their vector form, are notbound to the chromosome. In the present specification, “plasmid” and“vector” are used interchangeably as the plasmid is the most commonlyused form of vector. However, the invention is intended to include suchother forms of expression vectors which serve equivalent functions andwhich become known in the art subsequently hereto.

Certain Unmethylated CpG Containing Nucleic Acids Have B CellStimulatory Activity as Shown in vitro and in vivo

In the course of investigating the lymphocyte stimulatory effects of twoantisense oligonucleotides specific for endogenous retroviral sequences,using protocols described in the attached Examples 1 and 2, it wassurprisingly found that two out of twenty-four “controls” (includingvarious scrambled, sense, and mismatch controls for a panel of“antisense” ODN) also mediated B cell activation and IgM secretion,while the other “controls” had no effect.

Two observations suggested that the mechanism of this B cell activationby the “control” ODN may not involve antisense effects 1) comparison ofvertebrate DNA sequences listed in GenBank showed no greater homologythan that seen with non-stimulatory ODN and 2) the two controls showedno hybridization to Northern blots with 10 μg of spleen poly A+ RNA.Resynthesis of these ODN on a different synthesizer or extensivepurification by polyacrylamide gel electrophoresis or high pressureliquid chromatography gave identical stimulation, eliminating thepossibility of an impurity. Similar stimulation was seen using B cellsfrom C3H/HeJ mice, eliminating the possibility that lipopolysaccharide(LPS) contamination could account for the results.

The fact that two “control” ODN caused B cell activation similar to thatof the two “antisense” ODN raised the possibility that all four ODN werestimulating B cells through some non-antisense mechanism involving asequence motif that was absent in all of the other nonstimulatorycontrol ODN. In comparing these sequences, it was discovered that all ofthe four stimulatory ODN contained CpG dinucleotides that were in adifferent sequence context from the nonstimulatory control.

To determine whether the CpG motif present in the stimulatory ODN wasresponsible for the observed stimulation, over 300 ODN ranging in lengthfrom 5 to 42 bases that contained methylated, unmethylated, or no CpGdinucleotides in various sequence contexts were synthesized. These ODNs,including the two original “controls” (ODN 1 and 2) and two originallysynthesized as “antisense” (ODN 3D and 3M; Krieg, A. M. J. Immunol.143:2448 (1989)), were then examined for in vitro effects on spleencells (representative sequences are listed in Table 1). Several ODN thatcontained CpG dinucleotides induced B cell activation and IgM secretion;the magnitude of this stimulation typically could be increased by addingmore CpG dinucleotides (Table 1; compare ODN 2 to 2a or 3D to 3Da and3Db). Stimulation did not appear to result from an antisense mechanismor impurity. ODN caused no detectable proliferation of γδ or other Tcell populations.

Mitogenic ODN sequences uniformly became nonstimulatory if the CpGdinucleotide was mutated (Table 1; compare ODN 1 to 1a; 3D to 3Dc; 3M to3Ma; and 4 to 4a) or if the cytosine of the CpG dinucleotide wasreplaced by 5-methylcytosine (Table 1; ODN 1b, 2b, 3Dd, and 3Mb).Partial methylation of CpG motifs caused a partial loss of stimulatoryeffect (compare 2a to 2c, Table 1). In contrast, methylation of othercytosines did not reduce ODN activity (ODN 1c, 2d, 3De and 3Mc). Thesedata confirmed that CpG motif is the essential element present in ODNthat activate B cells.

In the course of these studies, it became clear that the bases flankingthe CpG dinucleotide played an important role in determining the murineB cell activation induced by an ODN. The optimal stimulatory motif wasdetermined to consist of a CpG flanked by two 5′ purines (preferably aGpA dinucleotide) and two 3′ pyrimidines (preferably a TpT or TpCdinucleotide). Mutations of ODN to bring the CpG motif closer to thisideal improved stimulation (e.g., Table 1, compare ODN 2 to 2e; 3M to3Md) while mutations that disturbed the motif reduced stimulation (e.g.,Table 1, compare ODN 3D to 3Df; 4 to 4b, 4c and 4d). On the other hand,mutations outside the CpG motif did not reduce stimulation (e.g., Table1, compare ODN to 1d; 3D to 3Dg; 3M to 3Me). For activation of humancells, the best flanking bases are slightly different (See Table 5)).

Of those tested, ODNs shorter than 8 bases were non-stimulatory (e.g.,Table 1, ODN 4e). Among the forty-eight 8 base ODN tested, a highlystimulatory sequence was identified as TCAACGTT (SEQ. ID. NO: 90) (ODN4)which contains the self complementary “palindrome” AACGTT (SEQ. ID. NO:105). In further optimizing this motif, it was found that ODN containingGs at both ends showed increased stimulation, particularly if the ODNwere rendered nuclease resistant by phosphorothioate modification of theterminal internucleotide linkages. ODN 1585 (5′GGGGTCAACGTTGAGGGGGG 3′(SEQ ID NO:12)), in which the first two and last five internucleotidelinkages are phosphorothioate modified caused an average 25.4 foldincrease in mouse spleen cell proliferation compared to an average 3.2fold increase in proliferation included by ODN 1638, which has the samesequence as ODN 1585 except that the 10 Gs at the two ends are replacedby 10 As. The effect of the G-rich ends is cis; addition of an ODN withpoly G ends but no CpG motif to cells along with 1638 gave no increasedproliferation. For nucleic acid molecules longer than 8 base pairs,non-palindromic motifs containing an unmethylated CpG were found to bemore immunostimulatory.

TABLE 1 Stimulation Index′ ODN Sequence (5′ to 3′)† ³H Uridine IgMProduction 1 (SEQ ID NO:89) GCTAGACGTTAGCGT 6.1 ± 0.8 17.9 ± 3.6  1a(SEQ ID NO:4) ......T........ 1.2 ± 0.2 1.7 ± 0.5 1b (SEQ ID NO:13)......Z........ 1.2 ± 0.1 1.8 ± 0.0 1c (SEQ ID NO:14) ............Z..10.3 ± 4.4  9.5 ± 1.8 1d (SEQ ID NO:6) ..AT......GAGC. 13.0 ± 2.3  18.3± 7.5  2 (SEQ ID NO:1) ATGGAAGGTCCAGCGTTCTC 2.9 ± 0.2 13.6 ± 2.0  2a(SEQ ID NO:15) ..C..CTC..G......... 7.7 ± 0.8 24.2 ± 3.2  2b (SEQ IDNO:16) ..Z..CTC.ZG..Z...... 1.6 ± 0.5 2.8 ± 2.2 2c (SEQ ID NO:17)..Z..CTC..G......... 3.1 ± 0.6 7.3 ± 1.4 2d (SEQ ID NO:18)..C..CTC..G......Z.. 7.4 ± 1.4 27.7 ± 5.4  2e (SEQ ID NO:19)............A....... 5.6 ± 2.0 ND 3D (SEQ ID NO:20) GAGAACGCTGGACCTTCCAT4.9 ± 0.5 19.9 ± 3.6  3Da (SEQ ID NO:21) .........C.......... 6.6 ± 1.533.9 ± 6.8  3Db (SEQ ID NO:22) .........C.......G.. 10.1 ± 2.8  25.4 ±0.8  3Dc (SEQ ID NO:23) ...C.A.............. 1.0 ± 0.1 1.2 ± 0.5 3Dd(SEQ ID NO:24) .....Z.............. 1.2 ± 0.2 1.0 ± 0.4 3De (SEQ IDNO:25) .............Z...... 4.4 ± 1.2 18.8 ± 4.4  3Df (SEQ ID NO:26).......A............ 1.6 ± 0.1 7.7 ± 0.4 3Dg (SEQ ID NO:27).........CC.G.ACTG.. 6.1 ± 1.5 18.6 ± 1.5  3M (SEQ ID NO:28)TCCATGTCGGTCCTGATGCT 4.1 ± 0.2 23.2 ± 4.9  3Ma (SEQ ID NO:29)......CT............ 0.9 ± 0.1 1.8 ± 0.5 3Mb (SEQ ID NO:30).......Z............ 1.3 ± 0.3 1.5 ± 0.6 3Mc (SEQ ID NO:31)...........Z........ 5.4 ± 1.5 8.5 ± 2.6 3Md (SEQ ID NO:7)......A..T.......... 17.2 ± 9.4  ND 3Me (SEQ ID NO:32)...............C..A. 3.6 ± 0.2 14.2 ± 5.2  4 (SEQ ID NO:90) TCAACGTT 6.1± 1.4 19.2 ± 5.2  4a (SEQ ID NO:91)    ....GC.. 1.1 ± 0.2 1.5 ± 1.1 4b(SEQ ID NO:92)    ...GCGC. 4.5 ± 0.2 9.6 ± 3.4 4c (SEQ ID NO:93)   ...TCGA. 2.7.± 1.0 ND 4d (SEQ ID NO:94)    ..TT..AA 1.3 ± 0.2 ND 4e(Residue 2-8 of    -....... 1.3 ± 0.2 1.1 ± 0.5 SEQ ID NO:90; SEQ IDNO:106) 4f (SEQ ID NO:95)    C....... 3.9 ± 1.4 ND 4g (Residue 11-18   --......CT 1.4 ± 0.3 ND of SEQ ID NO:19; SEQ ID NO:117) 4h (SEQ IDNO:96)    .......C 1.2 ± 0.2 ND ′Stimulation indexes are the means andstd. dev. derived from at least 3 separate experiments, and are comparedto wells cultured with no added ODN. ND = not done. CpG dinucleotidesare underlined. Dots indicate identity; dashes indicate deletions. Z = 5methyl cytosine.

TABLE 2 Identification of the optimal CpG motif for Murine IL-6production and B cell activation. IL-6 (pg/ml)^(a) ODN SEQUENCE (5′-3′)CH12.LX SPLENIC B CELL SI^(b) IgM (ng/ml)^(c) 512 (SEQ ID No:28)TCCATGTCGGTCCTGATGCT  300 ± 106  627 ± 43 5.8 ± 0.3  7315 ± 1324 1637(SEQ ID No:33) ......C.............  136 ± 27  46 ± 6 1.7 ± 0.2 770 ±72  1615 (SEQ ID No:34) ......G............. 1201 ± 155  850 ± 202 3.7 ±0.3 3212 ± 617  1614 (SEQ ID No:35) ......A............. 1533 ± 321 1812± 103 10.8 ± 0.6  7558 ± 414  1636 (SEQ ID No:36) .........A..........1181 ± 76  947 ± 132 5.4 ± 0.4 3983 ± 485  1634 (SEQ ID No:37).........C.......... 1049 ± 223 1671 ± 175 9.2 ± 0.9 6256 ± 261  1619(SEQ ID No:38) .........T.......... 1555 ± 304 2908 ± 129 12.5 ± 1.0 8243 ± 698  1618 (SEQ ID No:7) ......A..T.......... 2109 ± 291 2596 ±166 12.9 ± 0.7  10425 ± 674  1639 (SEQ ID No:3) .....AA..T..........1827 ± 83 2012 ± 132 11.5 ± 0.4  9489 ± 103  1707 (SEQ ID No:39)......A..TC......... ND 1147 ± 175 4.0 ± 0.2 3534 ± 217  1708 (SEQ IDNo:40 .....CA..TG......... ND  59 ± 3 1.5 ± 0.1 466 ± 109 Dots indicateidentity; CpG dinucleotides are underlined; ND = not done ^(a)Theexperiment was done at least three times with similar results. The levelof IL-6 of unstimulated control cultures of both CH12.LX and splenic Bcells was ≦10 pg/ml. The IgM level of unstimulated culture was 547 ± 82ng/ml. CpG dinucleotides are underlined and dots indicate identity.Cells were stimulated with 20 μM of various CpG O-ODN. Data present themean ± SD of triplicates. ^(b)[³H] Uridine uptake was indicated as afold increase (SI: stimulation index) from unstimulated control (2322.67± 213.68 cpm). ^(c)Measured by ELISA.

Other octamer ODN containing a 6 base palindrome with a TpC dinucleotideat the 5′ end were also active (e.g., Table 1, ODN 4b, 4c). Otherdinucleotides at the 5′ end gave reduced stimulation (e.g., ODN 4f, allsixteen possible dinucleotides were tested). The presence of a 3′dinucleotide was insufficient to compensate for the lack of a 5′dinucleotide (e.g., Table 1, ODN 4g). Disruption of the palindromeeliminated stimulation in octamer ODN (e.g., Table 1, ODN 4h), butpalindromes were not required in longer ODN.

The kinetics of lymphocyte activation were investigated using mousespleen cells. When the cells were pulsed at the same time as ODNaddition and harvested just four hours later, there was already atwo-fold increase in ³H uridine incorporation. Stimulation peaked at12-48 hours and then decreased. After 24 hours, no intact ODN weredetected, perhaps accounting for the subsequent fall in stimulation whenpurified B cells with or without anti-IgM (at a submitogenic dose) werecultured with CpG ODN, proliferation was found to synergisticallyincrease about 10-fold by the two mitogens in combination after 48hours. The magnitude of stimulation was concentration dependent andconsistently exceeded that of LPS under optimal conditions for both.Oligonucleotides containing a nuclease resistant phosphorothioatebackbone were approximately two hundred times mor potent than unmodifiedoligonucleotides.

Cell cycle analysis was used to determine the proportion of B cellsactivated by CpG-ODN. CpG-ODN induced cycling in more than 95% of Bcells. Splenic B lymphocytes sorted by flow cytometry into CD23−(marginal zone) and CD23+ (follicular) subpopulations were equallyresponsive to ODN-induced stimulation, as were both resting andactivated populations of B cells isolated by fractionation over Percollgradients. These studies demonstrated that CpG-ODN induced essentiallyall B cells to enter the cell cycle.

Immunostimulatory Nucleic Acid Molecules Block Murine B Cell Apoptosis

Certain B cell lines, such as WEHI-231, are induced to undergo growtharrest and/or apoptosis in response to crosslinking of their antigenreceptor by anti-IgM (Jakway, J. P. et al., “Growth regulation of the Blymphoma cell line WEHI-231 by anti-immunoglobulin, lipopolysaccharideand other bacterial products” J. Immunol. 137: 2225 (1986); Tsubata, T.,J. Wu and T. Honjo: B-cell apoptosis induced yb antigen receptorcrosslinking is blocked by a T-cell signal through CD40.” Nature 365:645 (1993)). WEHI-231 cells are rescued from this growth arrest bycertain stimuli such as LPS and by the CD40 ligand. ODN containing theCpG motif were also found to protect WEHI-231 from anti-IgM inducedgrowth arrest, indicating that accessory cell populations are notrequired for the effect. Subsequent work indicates that CpG ODN induceBc1-x and myc expression, which may account for the protection fromapoptosis. Also, CpG nucleic acids have been found to block apoptosis inhuman cells. This inhibition of apoptosis is important, since it shouldenhance and prolong immune activation by CpG DNA.

Identification of the Optimal CpG Motif for Induction of Murine IL-6 andIgM Secretion and B Cell Proliferation

To evaluate whether the optimal B cell stimulatory CpG motif wasidentical with the optimal CpG motif for IL-6 secretion, a panel of ODNin which the bases flanking the CpG dinucleotide were progressivelysubstituted was studied. This ODN panel was analyzed for effects on Bcell proliferation, Ig production, and IL-6 secretion, using bothsplenic B cells and CH12.LX cells. As shown in Table 2, the optimalstimulatory motif contains an unrmethylated CpG flanked by two 5′purines and two 3′ pyrimidines. Generally a mutation of either 5′purines to C were especially deleterious, but changes in 5′ purines to Tor 3′ pyrimidines to purines had less marked effects. Based on analysesof these and scores of other ODN, it was determined that the optimal CpGmotif for induction of IL-6 secretion is TGACGTT (SEQ. ID. NO: 108),which is identical with the optimal mitogenic and IgM-inducing CpG motif(Table 2). This motif was more stimulatory than any of the palindromecontaining sequences studied (1639, 1707 and 1708).

Induction of Murine Cytokine Secretion by CpG Motifs in Bacterial DNA orOligonucleotides

As described in Example 9, the amount of IL-6 secreted by spleen cellsafter CpG DNA stimulation was measured by ELISA. T cell depleted spleencell cultures rather than whole spleen cells were used for in vitrostudies following preliminary studies showing that T cells contributelittle or nothing to the IL-6 produced by CpG DNA-stimulated spleencells. As shown in Table 3, IL-6 production was markedly increased incells cultured with E. coli DNA but not in cells cultured with calfthymus DNA. To confirm that the increased IL-6 production observed withE. coli DNA was not de to contamination by other bacterial products, theDNA was digested with DNAse prior to analysis. DNAse pretreatmentabolished IL-6 production induced by E. coli DNA (Table 3). In addition,spleen cells from LPS-nonresponsive C2H/HeJ mouse produced similarlevels of IL-6 in response to bacterial DNA. To analyze whether the IL-6secretion induced by E. coli DNA was mediated by the unmethylated CpGdinucleotides in bacterial DNA, methylated E. coli DNA and a panel ofsynthetic ODN were examined. As shown in Table 3, CpG ODN significantlyinduced IL-6 secretion (ODN 5a, 5b, 5c) while CpG methylated E. coliDNA, or ODN containing methylated CpG (ODN 5f) or no CpG (ODN 5d) didnot. Changes at sites other than CpG dinucleotides (ODN 5b) ormethylation of other cytosines (ODN 5g) did not reduce the effect of CpGODN. Methylation of a single CpG in an ODN with three CpGs resulted in apartial reduction in the stimulation (compare ODN 5c to 5e; Table 3).

TABLE 3 Induction of Murine IL-6 secretion by CpG motifs in bacterialDNA or oligonucleotides. Treatment IL-6 (pg/ml) calf thymus DNA ≦10 calfthymus DNA + DNase ≦10 E. coli DNA 1169.5 ± 94.1 E. coli DNA + DNase ≦10CpG methylated E. coli DNA ≦10 LPS 280.1 ± 17.1 Media (no DNA) ≦10 5aSEQ. ID. ATGGACTCTCCAGCGTTCTC 1096.4 ± 372.0 No:115 5b SEQ. ID......AGG....A....... 1124.5 ± 126.2 No:19 5c SEQ. ID...C.......G......... 1783.0 ± 189.5 No:15 5d SEQ. ID. ....AGG..C..T...... ≦10 No:114 5e SEQ. ID. ..C.......G..Z......  851.1 ±114.4 No:116 5f SEQ. ID. ..Z......ZG..Z...... ≦10 No:16 5g SEQ. ID...C.......G......Z.. 1862.3 ± 87.26  No:18 T cell depleted spleen cellsfrom DBA/2 mice were stimulated with phosphodiester modifiedoligonucleotides (O-ODN) (20 μM), calf thymus DNA (50 μg/ml) or E. coliDNA (50 μg/ml) with or without enzyme treatment, or LPS (10 μg/ml) for24 hr. Data represent the mean (pg/ml) ± SD of triplicates. CpGdinucleotides are underlined and dots indicate identity. Z indicates5-methylcytosine.

CpG Motifs can be Used as an Artificial Adjuvant

Nonspecific simulators of the immune response are known as adjuvants.The use of adjuvants is essential to induce a strong antibody responseto soluble antigens (Harlow and Lan, Antibodies: A Laboratory manual,Cold Spring harbor, N.Y. Current Edition; hereby incorporated byreference). The overall effect of adjuvants is dramatic and theirimportance cannot be overemphasized. The action of an adjuvant allowsmuch smaller doses of antigen to be used and generates antibodyresponses that are more persistent. The nonspecific activation of theimmune response often can spell the difference between success andfailure in obtaining an immune response. Adjuvants should be used forfirst injections unless there is some very specific reason to avoidthis. Most adjuvants incorporate two components. One component isdesigned to protect the antigen from rapid catabolism (e.g., liposomesor synthetic surfactants (Hunter et al. 1981)). Liposomes are onlyeffective when the immunogen is incorporated into the outer lipid layer;entrapped molecules are not seen by the immune system. The othercomponent is a substance that will stimulate the immune responsenonspecifically. These substances act by raising the level oflymphokines. Lymphokines stimulate the activity of antigen-processingcells directly and cause a local inflammatory reaction at the site ofinjection. Early work relied entirely on heat-killed bacteria (Dienes1936) or lipopolysaccharide (LPS) (Johnson et al. 1956). LPS isreasonably toxic, and, through analysis of its structural components,most of its properties as an adjuvant have been shown to be in a portionknown as lipid A. Lipid A is available in a number of synthetic andnatural forms that are much less toxic than LPS, but still retains mostof the better adjuvant properties of parental LPS molecule. Lipid Acompounds are often delivered using liposomes.

Recently an intense drive to find potent adjuvants with more acceptableside effects has led to the production of new synthetic adjuvants. Thepresent invention provides the sequence 1826 TCCATGACGTTCCTGACGTT (SEQID NO: 10), which is an adjuvant including CpG containing nucleic acids.The sequence is a strong immune activating sequence and is a superbadjuvant, with efficacy comparable or superior to complete Freund's, butwithout apparent toxicity.

Titration of Induction of Murine IL-6 Secretion by CpG Motifs

Bacterial DNA and CpG ODN induced IL-6 production in T cell depletedmurine spleen cells in a dose-dependent manner, but vertebrate DNA andnon-CpG ODN did not (FIG. 1). IL-6 production plateaued at approximately50 μg/ml of bacterial DNA or 40 μM of CpG O—ODN. The maximum levels ofIL-6 induced by bacterial DNA and CpG ODN were 1-1.5 ng/ml and 2-4 ng/mlrespectively. These levels were significantly greater than thoseseen-after stimulation by LPS (0.35 ng/ml) (FIG. 1A). To evaluatewhether CpG ODN with a nuclease-resistant DNA backbone would also induceIL-6 production, S—ODN were added to T cell depleted murine spleencells. CpG S—ODN also induced IL-6 production in a dose-dependent mannerto approximately the same level as CpG O—ODN while non-CpG S—ODN failedto induce IL-6 (FIG. 1C). CpG S—ODN at a concentration of 0.05 μM couldinduce maximal IL-6 production in these cells. This result indicted thatthe nuclease-resistant DNA backbone modification retains the sequencespecific ability of CpG DNA to induce IL-6 secretion and that CpG S—ODNare more than 80-fold more potent than CpG O—ODN in this assay system.

Induction of Murine IL-6 Murine by CpG DNA in vivo

To evaluate the ability of bacterial DNA and CpG S—ODN to induce Il-6secretion in vivo, BALB/c mice were injected iv. with 100 μg of E. coliDNA, calf thymus DNA, or CpG or non-stimulatory S—ODN and bled 2 hrafter stimulation. The level of IL-6 in the sera from the E. coli DNAinjected group as approximately 13 ng/ml while IL-6 was not detected inthe sera from calf thymus DNA or PBS injected groups (Table 4). CpGS—ODN also induced IL-6 secretion in vivo. The IL-6 level in the serafrom CpG S—ODN injected groups was approximately 20 ng/ml. In contrast,IL-6 was not detected in the sera from non-stimulatory S—ODN stimulatedgroup (Table 4).

TABLE 4 Secretion of Murine IL-6 induced by CpG DNA stimulation in vivo.Stimulant IL-6 (pg/ml) PBS <50 E. coliDNA 13858 ± 3143 Calf Thymus DNA<50 CpG S-ODN 20715 ± 606  non-CpG S-ODN <50 Mice (2 mice/group) werei.v. injected with 100 μl of PBS, 200 μl of E. coli DNA or calf thymusDNA, or 500 μg of CpG S-ODN or non-CpG control S-ODN. Mice were bled 2hr after injection and 1:10 dilution of each serum was analyzed by IL-6ELISA. Sensitivity limit of IL-6 ELISA was 5 pg/ml. Sequences of the CpGS-ODN is 5′GCATGACGTTGAGCT3′(SEQ. ID. No:6) and of the non-stimulatoryS-ODN is 5′GCTAGATGTTAGCGT3′(SEQ. ID. No:4). Note that although there isa CpG in sequence 48, # it is too close to the 3′ end to effectstimulation, as explained herein. Data represent mean ± SD ofduplicates. The experiment was done at least twice with similar results.

Kinetics of Murine IL-6 Secretion After Stimulation by CpG Motifs invivo

To evaluate the kinetics of induction of IL-6 secretion by CpG DNA nvivo, BALB/c mice were injected iv. with CpG or control non-CpG S—ODN.Serum IL-6 levels were significantly increased within 1 hr and peaked at2 hr to a level of approximately 9 ng/ml in the CpG S—ODN injected group(FIG. 2). Il-6 protein in sera rapidly decreased after 4 hr and returnedto basal level by 12 hr after stimulation. In contrast to CpG DNAstimulated groups, no significant increase of IL-6 was observed in thesera from the non-stimulatory S—ODN or PBS injected groups (FIG. 2).

Tissue Distribution and Kinetics of IL-6, mRNA Expression Induced by CpGMotifs in vivo

As shown in FIG. 2, the level of serum IL-6 increased rapidly after CpGDNA stimulation. To investigate the possible tissue origin of this serumIL-6, and the kinetics of IL-6 gene expression in vivo after CpG DNAstimulation, BALB/c mice were injected iv with CpG or non-CpG S—ODN andRNA was extracted from liver, spleen, thymus, and bone marrow at varioustime points after stimulation. As shown in FIG. 3A, the level of IL-6mRNA in liver, spleen, and thymus was increased within 30 min. afterinjection of CpG S—ODN. The liver IL-6 mRNA peaked at 2 hrpost-injection and rapidly decreased and reached basal level 8 hr afterstimulation (FIG. 3A). Splenic IL-6 mRNA peaked at 2 hr afterstimulation and then gradually decreased (FIG. 3A). Thymus IL-6 mRNApeaked at 1 hr post-injection and then gradually decreased (FIG. 3A).IL-6 mRNA was significantly increased in bone marrow within 1 hr afterCpG S—ODN injection but then returned to basal level. In response to CpGS—ODN, liver, spleen and thymus showed more substantial increases inIL-6 mRNA expression than the bone marrow.

Patterns of Murine Cytokine Expression Induced by CpG DNA

In vivo or in whole spleen cells, no significant increase in the proteinlevels of the following interleukins: IL-2, IL-3, IL-4, IL-5, or IL-10was detected within the first six hours (Klinnan, D. M. et al., (1996)Proc. Natl. Acad. Sci. USA 93:2879-2883). However, the level of TNF-α isincreased within 30 minutes and the level of IL-6 increased strikinglywithin 2 hours in the serum of mice injected with CpG ODN. Increasedexpression of IL-12 and interferon gamma (IFN-γ) mRNA by spleen cellswas also detected within the first two hours.

TABLE 5 TNF- IFN- GM- ODN Sequence(5″-3″) IL-6₁ α₁ γ₁ CSF IL-11 512TCCATGTCGGT 500 140 15.6 70 250 SEQ ID NO:28 CCTGATGCT 1637 . . . C_. .. 550 16 7.8 15.6 16 SEQ ID NO:33 1615 . . . G_. . . 600 145 7.8 45 145SEQ ID NO:34 1614 . . . A_. . . 550 31 0 50 31 SEQ ID NO:35 1636 . . ._A . . . 325 400 35 40 250 SEQ ID NO:36 1634 . . . _C . . . 300 400 4085 400 SEQ ID NO:37 1619 . . . _T . . . 275 450 200 80 450 SEQ ID NO:381618 . . . A_T . . . 300 60 15.6 15.6 62 SEQ ID NO:7 1639 . . . AA_T . .. 625 220 15.6 40 220 SEQ ID NO:3 1707 . . . A_TC . . . 300 70 17 0 70SEQ ID NO:39 1708 . . . CA_TG . . . 270 10 17 ND 10 SEQ ID NO:40 dotsindicate identity; CpG dinucleotides are underlined ¹measured by ELISAusing Quantikine kits from R&D Systems (pg/ml) Cells were cultured in10% autologous serum with the indicated oligodeoxynucleotides (12 μg/ml)for 4 hr in the case of TNF-α or 24 hr for the other cytokines beforesupernatant harvest and assay. Data are presented as the level ofcytokine above that in wells with no added oligodeoxynucleotide.

CpG DNA Induces Cytokine Secretion by Human PBMC, Specifically Monocytes

The same panels of ODN used for studying mouse cytokine expression wereused to determine whether human cells also are induced by CpG motifs toexpress cytokine (or proliferate), and to identify the CpG motif(s)responsible. Oligonucleotide 1619 (GTCGTT; SEQ. ID. NO: 57) was the bestinducer of TNF-α and IFN-γ secretion, and was closely followed by anearly identical motif in oligonucleotide 1634 (GTCGCT; SEQ. ID. NO: 58)(Table 5). The motifs in oligodeoxynucleotides 1637 and 1614 (GCCGGT;SEQ. ID. NO: 109) and (GACGGT; SEQ. ID. NO: 110) led to strong IL-6secretion with relatively little induction of other cytokines. Thus, itappears that human lymphocytes, like murine lymphocytes, secretecytokines differentially in response to CpG dinucleotides, depending onthe surrounding bases. Moreover, the motifs that stimulate murine cellsbest differ from those that are most effective with human cells. CertainCpG oligodeoxynucleotides are poor at activating human cells(oligodeoxynucleotides 1707, 1708, which contain the palindrome formingsequences GACGTC (SEQ. ID. NO: 111) and CACGTG (SEQ. ID. NO: 112)respectively).

The cells responding to the DNA appear to be monocytes, since thecytokine secretion is abolished by treatment of the cells withL-leucyl-L-leucine methyl ester (L-LME), which is selectively toxic tomonocytes (but also to cytotoxic T lymphocytes and NK cells), and doesnot affect B cell Ig secretion (Table 6). The cells surviving L-LMEtreatment had >95% viability by trypan blue exclusion, indicating thatthe lack of a cytokine response among these cells did not simply reflecta nonspecific death of all cell types. Cytokine secretion in response toE. coli (EC) DNA requires unmethylated CpG motifs, since it is abolishedby methylation of the EC DNA (next to the bottom row, Table 6). LPScontamination of the DNA cannot explain the results since the level ofcontamination was identical in the native and methylated DNA, and sinceaddition of twice the highest amount of contaminating LPS had no effect(not shown).

TABLE 6 CpG DNA induces cytokine secretion by human PBMC TNF- IL-6 IFN-γRANTES DNA α(pg/ml)¹ (pg/ml) (pg/ml) (pg/ml) EC DNA (50 μg/ml) 90012,000 700 1560 EC DNA (5 μg/ml) 850 11,000 400 750 EC DNA (0.5 μg/ml)500 ND 200 0 EC DNA (0.05 μg/ml) 62.5 10,000 15.6 0 EC DNA (50 μg/ml) +0 ND ND ND L-LME₂ EC DNA (10 μg/ml) Methyl.₃ 0 5 ND ND CT DNA (50 μg/ml)0 600 0 0 ¹Levels of all cytokines were determined by ELISA usingQuantikine kits from R&D Systems as described in the previous table.Results are representative using PBMC from different donors. ²Cells werepretreated for 15 min. with L-leucyl-L-leucine methyl ester (M-LME) todetermine whether the cytokine production under these conditions wasfrom monocytes (or other L-LME-sensitive cells). ³EC DNA was methylatedusing 2U/μg DNA of CpG methylase (New England Biolabs) according to themanufacturer's directions, and methylation confirmed by digestion withHpa-II and Msp-I. As a negative control, samples were includedcontaining twice the maximal amount of LPS contained in the highestconcentration of EC DNA which failed to induce detectable cytokineproduction under these experimental conditions. ND = not done

The loss of cytokine production in the PBMC treated with L-LME suggestedthat monocytes may be responsible for cytokine production in response toCpG DNA. To test this hypothesis more directly, the effects of CpG DNAon highly purified human monocytes and macrophages was tested. Ashypothesized, CpG DNA directly activated production of the cytokinesIL-6, GM-CSF, and TNF-α by human macrophages, whereas non-CpG DNA didnot (Table 7).

TABLE 7 CpG DNA induces cytokine expression in purified humanmacrophages IL-6 (pg/ml) GM-CSF (pg/ml) TNF-α(pg/ml) Cells alone 0 0 0CT DNA (50 μg/ml) 0 0 0 EC DNA (50 μg/ml) 2000 15.6 1000

Biological Role of IL-6 in Inducing Murine IgM Production in Response toCpG Motifs

The kinetic studies described above revealed that induction of IL-6secretion, which occurs within 1 hr post CpG stimulation, precedes IgMsecretion. Since the optimal CpG motif for ODN inducing secretion ofIL-6 is the same as that for IgM (Table 2), whether the CpG motifsindependently induce IgM and IL-6 production or whether the IgMproduction is dependent on prior IL-6 secretion was examined. Theaddition of neutralizing anti-IL-6 antibodies inhibited in vitro IgMproduction mediated by CpG ODN in a dose-dependent manner but a controlantibody did not (FIG. 4A). In contrast, anti-IL-6 addition did notaffect either the basal level or the CpG-induced B cell proliferation(FIG. 4B).

Increased Transcriptional Activity of the IL-6 Promoter in Response toCpG DNA

The increased level of IL-6 mRNA and protein after CpG DNA stimulationcould result from transcriptional or post-transcriptional regulation. Todetermine if the transcriptional activity of the IL-6 promoter wasunregulated in B cells cultured with CpG ODN, a murine B cell line,WEHI-231, which produces IL-6 in response to CpG DNA, was transfectedwith an IL-6 promoter-CAT construct (pIL-6/CAT) (Pottrats, S. T. et al,17B-estradiol) inhibits expression of humaninterleukin-6-promoter-reporter constructs by a receptor-dependentmechanism. J. Clin. Invest. 93:944). CAT assays were performed afterstimulation with various concentrations of CpG or non-CpG ODN. As shownin FIG. 5, CpG ODN induced increased CAT activity in dose-dependentmanner while non-CPG ODN failed to induce CAT activity. This confirmsthat CpG induces the transcriptional activity of the IL-6 promoter.

Dependence of B Cell Activation by CpG ODN on the Number of 5′ and 3′Phosphorothioate Internucleotide Linkages

To determine whether partial sulfur modification of the ODN backbonewould be sufficient to enhance B cell activation, the effects of aseries of ODN with the same sequence, but with differing numbers of Sinternucleotide linkages at the 5′ end of ODN were required to provideoptimal protection of the ODN from degradation by intracellular exo- andendo-nucleases. Only chimeric ODN containing two 5′phosphorothioate-modified linkages, and a variable number of 3′ modifiedlinkages were therefore examined.

The lymphocyte stimulating effects of these ODN were tested at threeconcentrations (3.3, 10, and 30 μM) by measuring the total levels of RNAsynthesis (by ³H uridine incorporation) or DNA synthesis (by ³Hthymidine incorporation) in treated spleen cell cultures (Example 10).O—ODN (0/0 phosphorothioate modifications) bearing a CpG motif caused nospleen cell stimulation unless added to the cultures at concentrationsof at least 10 μM (Example 10). However, when this sequence was modifiedwith two S linkages at the 5′ end and at least three S linkages at the3′ end, significant stimulation was seen at a dose of 3.3 μM. At thislow dose, the level of stimulation showed a progressive increase as thenumber of 3′ modified bases was increased, until this reached orexceeded six, at which point the stimulation index began to decline. Ingeneral, the optimal number of 3′ S linkages for spleen cell stimulationwas five. Of all three concentrations tested in these experiments, theS—ODN was less stimulatory than the optimal chimeric compounds.

Dependent of GpG-mediated Lymphocyte Activation on the Type of BackboneModification

Phosphorothioate modified ODN (S—ODN) are far more nuclease resistantthan phosphodiester modified ODN (O—ODN). Thus, the increased immunestimulation caused by S—ODN and S—O—ODN (i.e., chimeric phosphorothioateODN in which the central linkages are phosphodiester, but the two 5′ andfive 3′ linkages are phosphorothioate modified) compared to O—ODN mayresult from the nuclease resistance of the former. To determine the roleof ODN nuclease resistance in immune stimulation by CpG ODN, thestimulatory effects of chimeric ODN in which the 5′ and 3′ ends wererendered nuclease resistant with either methylphosphonate (MP-),methylphosphorothioate (MPS-), phosphorothioate (S-), orphosphorodithioate (S₂-) internucleotide linkages were tested (Example10). These studies showed that despite their nuclease resistance,MP—O—ODN were actually less immune stimulatory than O—ODN. However,combining the MP and S modifications by replacing both nonbridging Omolecules with 5′, and 3′ MPS internucleotide linkages restored immunestimulation to a slightly higher level than that triggered by O—ODN.

S—O—ODN were far more stimulatory than O—ODN, and were even morestimulatory than S—ODN, at least at concentrations above 3.3 μM. Atconcentrations below 3 μM, the S—ODN with the 3M sequence was morepotent than the corresponding S—O—ODN, while the S—ODN with the 3Dsequence was less potent than the corresponding S—O—ODN (Example 10). Incomparing the stimulatory CpG motifs of these two sequences, it wasnoted that the 3D sequence is a perfect match for the stimulatory motifin that the CpG is flanked by two 5′ purines and two 3′ pyrimidines.However, the bases immediately flanking the CpG in ODN 3D are notoptimal; it has a 5′ pyrimidine and a 3′ purine. Based on furthertesting, it was found that the sequence requirement for immunestimulation is more stringent for S—ODN than for S—O— or O—ODN. S—ODNwith poor matches to the optimal CpG motif cause little or no lymphocyteactivation (e.g., Sequence 3D). However, S—ODN with good matches to themotif, most critically at the positions immediately flanking the CpG,are more potent than the corresponding S—O—ODN (e.g., Sequence 3M,Sequences 4 and 6), even though at higher concentrations (greater than 3μM) the peak effect from the S—O—ODN is greater (Example 10).

S₂—O—ODN were remarkably stimulatory, and caused substantially greaterlymphocyte activation than the corresponding S—ODN or S—O—ODN at everytested concentration.

The increased B cell stimulation seen with CpG ODN bearing S or S₂substitutions could result from any or all of the following effects:nuclease resistance, increased cellular uptake, increased proteinbinding, and altered intracellular localization. However, nucleaseresistance cannot be the only explanation, since the MP—O—ODN wereactually less stimulatory than the O—ODN with CpG motifs. Prior studieshave shown that ODN uptake by lymphocytes is markedly affected by thebackbone chemistry (Zhao, et al. (1993) Comparison of cellular bindingand uptake of antisense phosphodiester, phosphorothioate, and mixedphosphorothioate and methylphosphonate oligonucleotides. (AntisenseResearch and Development 3, 53-66; Zhao et al., (1994) Stage specificoligonucleotide uptake in murine bone marrow B cell precursors. Blood84, 3660-3666). The highest cell membrane binding and uptake was seenwith S—ODN, followed by S—O—ODN, O—ODN, and MP—ODN. This differentialuptake correlates with the degree of immune stimulation.

Unmethylated CpG Containing Oligos Have NK Cell Stimulatory Activity

Experiments were conducted to determine whether CpG containingoligonucleotides stimulated the activity of natural killer (NK) cells inaddition to B cells. As shown in Table 8, a marked induction of NKactivity among spleen cells cultured with CpG ODN 1 and 3Dd wasobserved. In contrast, there was relatively on induction in effectorsthat had been treated with non-CpG control ODN.

TABLE 8 Induction Of NK Activity By CpG Oligodeoxynucleotides (ODN) %YAC-1 % 2C11 Specific Lysis* Specific Lysis Effector: Target Effector:Target ODN 50:1 100:1 50:1 100:1 None −1.1 −1.4 15.3 16.6 1 16.1 24.538.7 47.2 3Dd 17.1 27.0 37.0 40.0 non-CpG ODN −1.6 −1.7 14.8 15.4

Induction of NK Activity by DNA Containing CpG Motifs, but Not byNon-CpG DNA

Bacterial DNA cultured for 18 hrs at 37° C. and then assayed for killingof K562 (human) or Yac-1 (mouse) target cells induced NK lytic activityin both mouse spleen cells depleted of B cells and human PBMC, butvertebrate DNA may be a consequence of its increased level ofunmethylated CpG dinucleotides, the activating properties of more than50 synthetic ODN containing unmethylated, methylated, or no CpGdinucleotides was tested. The results, summarized in Table 9,demonstrate that synthetic ODN can stimulate significant NK activity, aslong as they contain at least one unmethylated CpG dinucleotide. Nodifference was observed in the stimulatory effects of ODN in which theCpG was within a palindrome (such as ODN 1585, which contains thepalindrome AACGTT; SEQ. ID. NO: 105) from those ODN without palindromes(such as 1613 ro 1619), with the caveat that optimal stimulation wasgenerally seem with ODN in which the CpG was flanked by two 5′ purinesor a 5′ GpT dinucleotide and two 3′ pyrimidines. Kinetic experimentsdemonstrated that NK activity peaked around 18 hrs. after addition ofthe ODN. The data indicates that the murine NK response is dependent onthe prior activation of monocytes by CpG DNA, leading to the productionof IL-12, TNF-α, and IFN-α/b (Example 11).

TABLE 9 Induction of NK Activity by DNA Containing CpG Motifs but not byNon-CpG DNA LU/10⁶ DNA or Cytokine Added Mouse Cells Human Cells Expt. 1None 0.00 0.00 IL-2 16.68 15.82 E. Coli. DNA 7.23 5.05 Calf thymus DNA0.00 0.00 Expt. 2 None 0.00 3.28 1585 ggGGTCAACGTTGAGggggg (SEQ IDNo.12) 7.38 17.98 1629 -------gtc------ (SEQ ID No.41) 0.00 4.4 Expt. 3None 0.00 1613 GCTAGACGTTAGTGT (SEQ ID No. 42) 5.22 1769 -------Z------(SEQ ID No. 117) 0.02 ND 1619 TCCATGTCGTTCCTGATGCT (SEQ ID No. 38) 3.351765 --------Z---------- (SEQ ID No. 44) 0.11 CpG dinucleotides in ODNsequences are indicated by underlying; Z indicates methylcytosine. Lowercase letters indicate nuclease resistant phosphorothioate modifiedinternucleotide linkages which, in titration experiments, were more than20 times as potent as non-modified ODN, depending on the flanking bases.Poly G ends (g) were used in some ODN, because they significantlyincrease the level of ODN uptake.

From all of these studies, a more complete understanding of the immuneeffects of CpG DNA has been developed, which is summarized in FIG. 6.

Immune activation by CpG motifs may depend on bases flanking the CpG,and the number of spacing of the CpGs present within an ODN. Although asingle CpG in an ideal base context can be a very strong and usefulimmune activator, superior effects can be seen with ODN containingseveral CpGs with the appropriate spacing and flanking bases. Foractivation of murine B cells, the optimal CpG motif is TGACGTT (SEQ. ID.NO: 108); residues 10-17 of Seq. ID. No 70.

The following studies where conducted to identify optimal ODN sequencesfor stimulation of human cells by examining the effects of changing thenumber, spacing, and flanking bases of CpG dinucleotides.

Identification of Phosphorothioate ODN with Optimal CpG Motifs forActivation of Human NK Cells

To have clinical utility, ODN must be administered to a subject in aform that protects them against nuclease degradation. Methods toaccomplish this with phosphodiester ODN are well known in the art andinclude encapsulation in lipids or delivery systems such asnanoparticles. This protection can also be achieved using chemicalsubstitutions to the DNA such as modified DNA backbones including thosein which the internucleotide linkages are nuclease resistant. Somemodifications may confer additional desirable properties such asincreasing cellular uptake. For example, the phosphodiester linkage canbe modified via replacement of one of the nonbridging oxygen atoms witha sulfur, which constitutes phosphorothioate DNA. Phosphorothioate ODNhave enhanced cellular uptake (Krieg et al., Antisense Res. Dev. 6:133,1996.) and improved B cell stimulation if they also have a CpG motif.Since NK activation correlates strongly with in vivo adjuvant effects,the identification of phosphorothioate ODN that will activate human NKcells is very important.

The effects of different phosphorothioate ODNs—containing CpGdinucleotides in various base contexts—on human NK activation (Table 10)were examined. ODN 1840, which contained 2 copies of the TGTCGTT (SEQ.ID. NO: 102) residues 14-20 of SEQ. ID. NO: 47 motif, had significant NKlytic activity (Table 10). To further identify additional ODNs optimalfor NK activation, approximately one hundred ODN containing differentnumbers and spacing of CpG motifs, were tested with ODN1982 serving as acontrol. The result are shown in Table 1.

Effective ODNs began with a TC or TG at the 5′ end, however, thisrequirement was not mandatory. ODNs with internal CpG motifs (e.g., ODN1840) are generally less potent stimulators than those in which a GTCGCT(SEQ. ID. NO: 58) motif immediately follows the 5′ TC (e.g., ODN 1967and 1968). ODN 1968, which has a second GTCGTT SEQ. ID. NO: 57) motif inits 3′ half, was consistently more stimulatory than ODN 1967, whichlacks this second motif. ODN 1967, however, was slightly more potentthan ODN 1968 in experiments 1 and 3, but not in experiment 2. ODN 2005,which has a third GTCGTT (SEQ. ID NO. 57) motif, inducing slightlyhigher NK activity on average than 1968. However, ODN 2006, in which thespacing between the GTCGTT (SEQ. ID. NO: 57) motifs was increased by theaddition of two Ts between each motif, was superior to ODN 2005 and toODN 2007, in which only one of the motifs had the additional of thespacing two Ts. The minimal acceptable spacing between CpG motifs is onenucleotide as long as the ODN has two pyrimidines (preferably T) at the3′ end (e.g., ODN 2015). Surprisingly, joining two GTCGTT (SEQ. ID. NO:57) motifs end to end with a 5′ T also created a reasonably stronginducer of NK activity (e.g., ODN 2016). The choice of thymine (T)separating consecutive CpG dinucleotides is not absolute, since ODN 2002induced appreciable NK activation despite the fact that adenine (A)separated its CpGs (i.e., CGACGTT; SEQ. ID. NO: 113). It should also benoted that ODNs containing no CpG (e.g., ODN 1982), runs of CpGs, orCpGs in bad sequence contents (e.g., ODN 2010) had no stimulatory effecton NK activation.

TABLE 10 ODN LU cells alone Sequence (5′-3′) 0.01 1754ACCATGGACGATCTGTTTCCCCTC 0.02 SEQ ID NO:59 1758 TCTCCCAGCGTGCGCCAT 0.05SEQ ID NO:45 1761 TACCGCGTGCGACCCTCT 0.05 SEQ ID NO:60 1776ACCATGGACGAACTGTTTCCCCTC 0.03 SEQ ID NO:61 1777 ACCATGGACGAGCTGTTTCCCCTC0.05 SEQ ID NO:62 1778 ACCATGGACGACCTGTTTCCCCTC 0.01 SEQ ID NO:63 1779ACCATGGACGTACTGTTTCCCCTC 0.02 SEQ ID NO:64 1780 ACCATGGACGGTCTGTTTCCCCTC0.29 SEQ ID NO:65 1781 ACCATGGACGTTCTGTTTCCCCTC 0.38 SEQ ID NO:66 1823GCATGACGTTGAGCT 0.08 SEQ ID NO:6 1824 CACGTTGAGGGGCAT 0.01 SEQ ID NO:671825 CTGCTGAGACTGGAG 0.01 SEQ ID NO:68 1828 TCAGCGTGCGCC 0.01 SEQ IDNO:69 1829 ATGACGTTCCTGACGTT 0.42 SEQ ID NO:70 1830² RANDOM SEQUENCE0.25 1834 TCTCCCAGCGGGCGCAT 0.00 SEQ ID NO:71 1836 TCTCCCAGCGCGCGCCAT0.46 SEQ ID NO:72 1840 TCCATGTCGTTCCTGTCGTT 2.70 SEQ ID NO:73 1841TCCATAGCGTTCCTAGCGTT 1.45 SEQ ID NO:74 1842 TCGTCGCTGTCTCCGCTTCTT 0.06SEQ ID NO:75 1851 TCCTGACGTTCCTGACGTT 2.32 SEQ ID NO:76 ¹Lytic units(LU) were measured as described (8). Briefly, PBMC were collected fromnormal donors and spun over Ficoll, then cultured with or without theindicated ODN (which were added to cultures at 6 μg/ml) for 24 hr. Thentheir ability to lyse ⁵¹Cr-labeled K562 cells was determined. Theresults shown are typical of those obtained with several differentnormal human donors. ²This oligo mixture contained a random selection ofall 4 bases at each position.

Table 11. Induction of NK LU by Phosphorothioate CpG ODN with GoodMotifs

TABLE 11 Induction of NK LU by Phosphorothioate CpG ODN with Good MotifsODN¹ expt. 1 expt. 2 expt. 3 cells alone sequence (5′-3′) SEQ ID NO:0.00 1.26 0.46 1840 TCCATGTCGTTCCTGTCGTT 73 2.33 ND ND 1960TCCTGTCGTTCCTGTCGTT 77 ND 0.48 8.99 1961 TCCATGTCGTTTTTGTCGTT 78 4.031.23 5.08 1962 TCCTGTCGTTCCTTGTCGTT 52 ND 1.60 5.74 1963TCCTTGTCGTTCCTGTCGTT 121 3.42 ND ND 1965 TCCTGTCGTTTTTTGTCGTT 53 0.460.42 3.48 1966 TCGTCGCTGTCTCCGCTTCTT 75 2.62 ND ND 1967TCGTCGCTGTCTGCCCTTCTT 54 5.82 1.64 8.32 1968 TCGTCGCTGTTGTCGTTTCTT 553.77 5.26 6.12 1979 TCCATGTZGTTCCTGTZGTT 122 1.32 ND ND 1982TCCAGGACTTCTCTCAGGTT 79 0.05 ND 0.98 1990 TCCATGCGTGCGTGCGTTTT 80 2.10ND ND 1991 TCCATGCGTTGCGTTGCGTT 81 0.89 ND ND 2002 TCCACGACGTTTTCGACGTT82 4.02 1.31 9.79 2005 TCGTCGTTGTCGTTGTCGTT 47 ND 4.22 12.75 2006TCGTCGTTTTGTCGTTTTGTCGT 123 ND 6.17 12.82 2007 TCGTCGTTGTCGTTTTGTCGTT 49ND 2.68 9.66 2008 GCGTGCGTTGTCGTTGTCGTT 56 ND 1.37 8.15 2010GCGGCGGGCGGCGCGCGCCC 83 ND 0.01 0.05 2012 TGTCGTTTGTCGTTTGTCGTT 48 ND2.02 11.61 2013 TGTCGTTGTCGTTGTCGTTGTCGTT 84 ND 0.56 5.22 2014TGTCGTTGTCGTTGTCGTT 50 ND 5.74 10.89 2015 TCGTCGTCGTCGTT 51 ND 4.5310.13 2016 TGTCGTTGTCGTT 85 ND 6.54 8.06 ¹PBMC essentially as describedherein. Results are representative of 6 separate experiments; eachexperiment represents a different donor. ²This is the methylated versionof ODN 1840; Z = 5-methyl cytosine LU is lytic units; ND = not done; CpGdinucleotides are underlined for clarity.

Identification of Phosphorothioate ODN with Optimal CpG Motifs forActivation of Human B Cell Proliferation

The ability of a CpG ODN to induce B cell proliferation is a goodmeasure of its adjuvant potential. Indeed, ODN with strong adjuvanteffects generally also induce B cell proliferation. To determine whetherthe optimal CpG ODN for inducing B cell proliferation are the same asthose for inducing NK cell activity, similar panels of ODN (Table 12)were tested. The most consistent stimulation appeared with ODN 2006(Table 12).

TABLE 12 Induction of human B cell proliferation by Phosphorothioate CpGODN Stimulation Index¹ ODN sequence (5′-3′) SEQ ID NO: expt. 1 expt. 2expt. 3 expt 4 expt. 5 expt. 6 1840 TCCATGTCGTTCCTGTCGTT 73 4 ND ND NDND 34 1841 TCCATAGCGTTCCTAGCGTT 74 3 ND ND ND ND ND 1960TCCTGTCGTTCCTGTCGTT 77 ND 2.0 2.0 3.6 ND ND 1961 TCCATGTCGTTTTTGTCGTT 782 39 1.9 3.7 ND 37 1962 TCCTGTCGTTCCTTGTCGTT 52 ND 3.3 1.9 3.9 5.4 351963 TCCTTGTCGTTCCTGTCGTT 121 3 ND ND ND ND ND 1965 TCCTGTCGTTTTTTGTCGTT53 4 3.7 2.4 4.7 6.0 43 1967 TCGTCGCTGTCTGCCCTTCTT 54 ND 4.4 2.O 4.5 5.O36 1968 TCGTCGCTGTTGTCGTTTCTT 55 ND 4.O 2.O 4.9 87 38 1982TCCAGGACTTCTCTCAGGTT 79 3 1.8 1.3 3.1 3.2 1.2 2002 TCCACGACGTTTTCGACGTT86 ND 2.7 1.4 4.4 ND 14 2005 TCGTCGTTGTCGTTGTCGTT 47 5 3.2 1.2 3.0 7.937 2006 TCGTCGTTTTGTCGTTTTGTCGT 46 4 4.5 2.2 5.8 8.3 40 2007TCGTCGTTGTCGTTTTGTCGTT 49 3 4.0 4.2 4.1 ND 22 2008 GCGTGCGTTGTCGTTGTCGTT56 ND 3.0 2.4 1.6 ND 12 2010 GCGGCGGGCGGCGCGCGCCC 83 ND 1.6 1.9 3.2 NDND 2012 TGTCGTTTGTCGTTTGTCGTT 48 2 2.8 0 3.2 ND 33 2013TGTCGTTGTCGTTGTCGTTGTCGTT 84 3 2.3 3.1 2.8 ND  7 2014TGTCGTTGTCGTTGTCGTT 50 3 2.5 4.0 3.2 6.7 14 2015 TCGTCGTCGTCGTT 51 5 1.82.6 4.5 9.4  1 2016 TGTCGTTGTCGTT 85 ND 1.1 1.7 2.7 7.3  1 ¹Cells =human spleen cells stored at −70° C. after surgical harvest or PBMCcollected from normal donors and spun over Ficoll. Cells were culturedin 96 well U-bottom microtiter plates with or without the indicated ODN(which were added to cultures at 6 μml). N = 12 experiments. Cells werecultured for 4-7 days, pulsed with 1 μCi of ³H thymidine for 18 hr.before harvest and scintillation counting. Stimulation index = the ratioof cpm in wells # without ODN to that in wells that had been stimulatedthroughout the culture period with the indicated ODN (there were nofurther additions of ODN after the cultures were set up). ND = not done.

Identification of Phosphorothioate ODN that Induce Human IL-2 Secretion

The ability of a CpG ODN to induce IL-12 secretion is a good measure ofits adjuvant potential, especially in terms of its ability to induce aTh1 immune response, which is highly dependent on IL-12. Therefore, theability of a panel of phosphorothioate ODN to induce OIL-12 secretionfrom human PBMC in vitro (Table 13) was examined. These experimentsshowed that in some human PBMC, most CpG ODN could induce IL-12secretion (e.g., expt. 1). However, other donors responded to just a fewCpG ODN (E.g., expt. 2). ODN 2006 was a consistent inducer of IL12secretion from most subjects (Table 13).

TABLE 13 Induction of human IL-12 secretion by Phosphorothioate CpG ODNIL-12 (pg/ml) ODN¹ expt. 1 expt. 2 cells alone sequence (5′-3′) SEQ IDNO: 0 0 1962 TCCTGTCGTTCCTTGTCGTT 52 19 0 1965 TCCTGTCGTTTTTTGTCGTT 5336 0 1967 TCGTCGCTGTCTGCCCTTCTT 119 41 0 1968 TCGTCGCTGTTGTCGTTTCTT 12024 0 2005 TCGTCGTTGTCGTTGTCGTT 47 25 0 2006 TCGTCGTTTTGTCGTTTTGTCGTT 4629 15 2014 TGTCGTTGTCGTTGTCGTT 50 28 0 2015 TCGTCGTCGTCGTT 51 14 0 2016TGTCGTTGTCGTT 85 3 0 ¹PBMC were collected from normal donors and spunover Ficoll, then cultured at 10⁶ cells/we in 96 well microtiter plateswith or without the indicated ODN which were added to cultures a μg/ml.Supernatants were collected at 24 hr and tested for IL-12 levels byELISA as described methods. A standard curve was run in each experiment,which represents a different donor.

Identification of B Cell and Monocyte/NK Cell-specific Oligonucleotides

As shown in FIG. 6, CpG DNA can directly activate highly purified Bcells and monocytic cells. There are many similarities in the mechanismthrough which CpG DNA activates these cell types. For example, bothrequire NFκB activation as explained further below.

In further studies of different immune effects of CpG DNA, it was foundthat there is more than one type of CpG motif. Specifically, olio 1668,with the best mouse B cell motif, is a strong inducer of both B cell andnatural killer (NK) cell activation, while olio 1758 is a weak B cellactivator, but still induces excellent NK responses (Table 14).

TABLE 14 Different CpG motifs stimulate optimal murine B cell and NKactivation ODN Sequence B cell activation NK activation 1668TCCATGACGTTCCTGATGCT (SEQ.ID.NO 7) 42,849 2.52 1758 TCTCCCAGCGTGCGCCAT(SEQ.ID.NO.45)  1,747 6.66 NONE   367 0.00 CpG dinucleotides areunderlined; oligonucleotides were synthesized with phosphorothioatemodified backbones to improve their nuclease resistance. Measured by Hthymidine incorporation after 48 hr culture with oligodeoxynucleotidesat a 200 nM concentration as described in Example 1. Measured in lyticunits.

Teleological Basis of Immunostimulatory, Nucleic Acids

Vertebrate DNA is highly methylated and CpG dinucleotides are underrepresented. However, the stimulatory CpG motif is common in microbialgenomic DNA, but quite rare in vertebrate DNA. In addition, bacterialDNA has been reported to induce B cell proliferation and immunoglobulin(Ig) production, while mammalian DNA does not (Messina, J. P. et al., J.Immunol. 147:1759 (1991)). Experiments further described in Example 3,in which methylation of bacterial DNA with CpG methylase was found toabolish mitogenicity, demonstrates that the difference in CpG status isthe cause of B cell stimulation by bacterial DNA. This data supports thefollowing conclusion: that unmethylated CpG dinucleotides present withinbacterial DNA are responsible for the stimulatory effects of bacterialDNA.

Teleologically, it appears likely that lymphocyte activation by the CpGmotif represents an immune defense mechanism that can therebydistinguish bacterial from host DNA. Host DNA, which would commonly bepresent in many anatomic regions and areas of inflammation due toapoptosis (cell death), would generally induce little or mo lymphocyteactivation due to CpG suppression and methylation. However, the presenceof bacterial DNA containing unmethylated CpG motifs can cause lymphocyteactivation precisely in infected anatomic regions, where it isbeneficial. This novel activation pathway provides a rapid alternativeto T cell dependent antigen specific B cell activation. Since the CpGpathway synergizes with B cell activation through the antigen receptor,B cells bearing antigen receptor specific for bacterial antigens wouldreceive on e activation signal through cell membrane Ig and a secondsignal from bacterial DNA, and would therefore tend to be preferentiallyactivated. The interrelationship of this pathway with other pathways ofB cell activation provide a physiologic mechanism employing a polyclonalantigen to induce antigen-specific responses.

However, it is likely that B cell activation would not be totallynonspecific. B cells bearing antigen receptors specific for bacterialproducts could receive one activation signal through cell membrane Ig,and a second from bacterial DNA, thereby more vigorously triggeringantigen specific immune responses. As with other immune defensemechanisms, the response to bacterial DNA could have undesirableconsequences in some settings. For example, autoimmune responses to selfantigens would also tend to be preferentially triggered by bacterialinfections, since autoantigens could also provide a second activationsignal to autoreactive B cells triggered by bacterial DNA. Indeed theinduction of autoimmunity by bacterial infections is a common clinicalobservance. For example, the autoimmune disease systemic lupuserythematosus, which is: i) characterized by the production of anti-DNAantibodies; ii) induced by drugs which inhibit DNA methyltransferase(Comaccia, E. J. et al., J. Clin. Invest. 92:38 (1993)); and iii)associated with reduced DNA methylation (Richardson, B., L. et al.,Arth. Rheum 35:647 (1992)), is likely triggered at least in part byactivation of DNA-specific B cells through stimulatory signals providedby CpG motifs, as well as by binding of bacterial DNA to antigenreceptors.

Further, sepsis, which is characterized by high morbidity and mortalitydue to massive and nonspecific activation of the immune system may beinitiated by bacterial DNA and other products released from dyingbacteria that reach concentrations sufficient to directly activate manylymphocytes. Further evidence of the role of CpG DNA in the sepsissyndrome is described in Cowdery, J., et. al., (1996) the Journal ofImmunology 156:4570-4575.

Unlike antigens that trigger B cells through their surface Ig receptor,CpG-ODN did not induce any detectable Ca²⁺ flux, changes in proteintyrosine phosphorylation, or IP 3 generation. Flow cytometry withFITC-conjugated ODN with or without a CpG motif was performed asdescribed in Zhao, Q et al., (Antisense Research and Development 3:53-66(1993)), and showed equivalent membrane binding, cellular uptake,efflux, and intracellular localization. This suggests that there may notbe cell membrane proteins specific for CpG ODN. Rather than actingthrough the cell membrane, that data suggests that unmethylated CpGcontaining oligonucleotides require cell uptake for activity: ODNcovalently linked to a solid Teflon support were nonstimulatory, as werebiotinylated ODN immobilized on either avidin beads or avidin coatedpetri dishes. CpG ODN conjugated to either FITC or biotin retained fullmitogenic properties, indicated no stearic hindrance.

Recent data indicate the involvement of the transcription factor NFkB asa direct or indirect mediator of the CpG effect. For example, within 15minutes of treating B cells or monocytes with CpG DNA, the level of NFkBbinding activity is increased (FIG. 7). However, it is not increased byDNA that does not contain CpG motifs. In addition, it was found that twodifferent inhibitors of NFkB activation, PDTC and gliotoxin, completelyblock the lymphocyte stimulation by CpG DNA as measured by B cellproliferation or monocytic cell cytokine secretion, suggesting that NFkBactivation is required for both cell types.

There are several possible mechanisms through which NFkB can beactivated. These include through activation of various protein kinases,or through the generation of reactive oxygen species. No evidence forprotein kinase activation induced immediately after CpG DNA treatment ofB cells or monocytic cells have been found, and inhibitors of proteinkinase A, protein kinase C, and protein tyrosine kinases had no effectson the CpG induced activation. k However, CpG DNA causes a rapidinduction of the production of reactive oxygen species in both B cellsand monocytic cells, as detected by the sensitive fluorescent dyedihydrorhodamine 123 as described in Royall, J. A., and Ischiropoulos,H. (Archives of Biochemistry and Biophysics 302:348-355 (1993)).Moreover, inhibitors of the generation of these reactive oxygen speciescompletely block the induction of NFkB and the later induction of cellproliferation and cytokine secretion by CpG DNA.

Work backwards, the next question was how CpG DNA leads to thegeneration of reactive oxygen species so quickly. Previous studies bythe inventors demonstrated that oligonucleotides and plasmid orbacterial DNA are taken up by cells into endosomes. These endosomesrapidly become acidified inside the cell. To determine whether thisacidification step may be important in the mechanism through which CpGDNA activates reactive oxygen species, the acidification step wasblocked with specific inhibitors of endosome acidification includingchloroquine, monensin, and bafilomycin, which work through differentmechanisms. FIG. 8A shows the results from a flow cytometry study usingmouse B cells with the dihydrorhodamine 123 dye to determine levels ofreactive oxygen species. The dye only sample in Panel A of the figureshows the background level of cells positive for the dye at 28.6%. asexpected, this level of reactive oxygen species was greatly increased to80% in the cells treated for 20 minutes with PMA and ionomycin, apositive control (Panel B). The cells treated with the CpG oligo alsoshowed an increase in the level of reactive oxygen species such thatmore than 50% of the cells became positive (Panel D). However, cellstreated with an oligonucleotide with the identical sequence except thatthe CpG was switched did not show this significant increase in the levelof reactive oxygen species (Panel E).

In the presence of chloroquine, the results are very different (FIG.8B). Chloroquine slightly lowers the background level of reactive oxygenspecies in the cells such that the untreated cells in Panel A have only4.3% that are positive. Chloroquine completely abolishes the inductionof reactive oxygen species in the cells treated with CpG DNA (Panel B)but does not reduce the level of reactive oxygen species in t he cellstreated with PMA and ionomycin (Panel E). This demonstrates that unlikethe PMA plus ionomycin, the generation of reactive oxygen speciesfollowing treatment of B cells with CpG DNA requires that the DNAundergo an acidification step in the endosomes. This is a completelynovel mechanism of leukocyte activation. Chloroquine, monensin, andbafilomycin also appear to block the activation of NFkB by CpG DNA aswell as the subsequent proliferation and induction of cytokinesecretion.

Chronic Immune Activation by CpG DNA and Autoimmune Disorders

B cell activation by CpG DNA synergizes with signals through the B cellreceptor. This raises the possibility that DNA-specific B cells may beactivated by the concurrent binding of bacterial DNA to their antigenreceptor, and by the co-stimulatory CpG-mediated signals. In addition,CpG DNA induces B cells to become resistant to apoptosis, a mechanismthought to be important for preventing immune responses to selfantigens, such as DNA. Indeed, exposure to bDNA can trigger anti-DNA Abproduction. Given this potential ability of CpG DNA to promoteautoimmunity, it is therefore noteworthy that patients with theautoimmune disease systemic lupus erythematosus have persistentlyelevated levels of circulating plasma DNA which is enriched inhypomethylated CpGs. These findings suggest a possible role for chronicimmune activation by CpG DNA in lupus etiopathogenesis.

A class of medications effective in the treatment of lupus isantimalarial drugs, such as chloroquine. While the therapeutic mechanismof these drugs has been unclear, they are known to inhibit endosomalacidification. Leukocyte activation by CpG DNA is not medicated throughbinding to a cell surface receptor, but requires cell uptake, whichoccurs via adsorptive endocytosis into an acidifiedchloroquine-sensitive intracellular compartment. This suggested thehypothesis that leukocyte activation by CpG DNA may occur in associationwith acidified endosomes, and might even be pH dependent. To test thishypothesis specific inhibitors of DNA acidification were applied todetermine whether B cells or monocytes could respond to CpG DNA ifendosomal acidification was prevented.

The earliest leukocyte activation event that was detected in response toCpG DNA is the production of reactive oxygen species (ROS), which isinduced within five minutes in primary spleen cells and both B andmonocyte cell lines. Inhibitors of endosomal acidification includingchloroquine, bafilomycin A, and monensin, which have differentmechanisms of action, blocked the CpG-induced generation of ROS, but hadno effect on ROS generation mediated by PMA, or ligation of CD40 or IgM.These studies show that ROS generation is a common event in leukocyteactivation through diverse pathways. This ROS generation is generallyindependent of endosomal acidification, which is required only for theROS response to CpG DNA. ROS generation in response to CpG is notinhibited by the NFκB inhibitor gliotoxin, confirming that it is notsecondary to NFκB activation.

To determine whether endosomal acidification of CpG DNA was alsorequired for its other immune stimulatory effects were performed. BothLPS and CpG DNA induce similar rapid NFκB activation, increases inproto-oncogene mRNA levels, and cytokine secretion. Activation of NFκBby DNA depended on CpG motifs since it was not induced by bDNA treatedwith CpG methylase, nor by ODN in which bases were switched to disruptthe CpGs. Supershift experiments using specific antibodies indicatedthat the activated NFκB complexes included the p50 and p65 components.Not unexpectedly, NFκB activation in LPS- or CpG-treated cells wasaccompanied by the degradation of IκBα and IκBβ. However, inhibitors ofendosomal acidification selectively blocked all of the CpG-induced butnone of the LPS-induced cellular activation events. The very lowconcentration of chloroquine (<10 μM) that has been determined toinhibit CpG-mediated leukocyte activation is noteworthy since it is wellbelow that required for antimalarial activity and other reported immuneeffects (e.g., 100-1000 μM). These experiments support the role of apH-dependent signaling mechanism in mediating the stimulatory effects ofCpG DNA.

TABLE 15 Specific blockade of CpG-induced TNF-αand IL-12 expression byinhibitors of endosomal acidification or NFκB activation Inhibitors:Bafilomycin Chloroquine Monensin NAC TPCK Gliotoxin Bisgliotoxin Medium(250 nM) (2.5 μg/ml) (10 μM) (50 mM) (50 μM) (0.1 μg/ml) (0.1 μg/ml)activators TNF-α IL-12 TNF-α IL-12 TNF-α IL-12 TNF-α IL-12 TNF-α TNF-αTNF-α TNF-α Medium 37 147 46 102 27 20 22 73 10 24 17 41 CpG 455 17,11471 116 28 6 49 777 54 23 31 441 ODN LPS 901 22,485 1370 4051 1025 12418491 4796 417 46 178 1120

Table 15 legend IL-12 and TNF-α assays: The murine monocyte cell lineJ774 (1×10⁵ cells/ml for IL-12 or 1×10⁶ cells/ml for TNF-α), werecultured with or without the indicated inhibitors at the concentrationsshown for 2 hr and then stimulated with the CpG oligodeoxynucleotide(ODN) 1826 (TCCATGACGTTCCTGACGTT SEQ ID NO:10) at 2 μM or LPS (10 μg/ml)for 4 hr (TNF-α) or 24 hr (IL-12) at which time the supernatant washarvested. ELISA for IL-12 or TNF-α (pg/ml) was performed on thesupernatants essentially as described (A. K. Krieg, A.-K. Yi, S. Matson,T. J. Waldschmidt, G. A. Bishop, R. Teasdale, G. Koretzky and D.Klinman, Nature 374, 546 (1995); Yi, A.-K., D. M. Kilnman, T. L. Martin,S. Matson and A. M. Krieg, J. Immunol., 157, 5394-5402 (1996); Krieg, A.M., J. Lab. Clin. Med., 128, 128-133 (1996). Cells cultured with ODNthat lacked CpG motifs did not induce cytokine secretion. Similarspecific inhibition of CpG responses was seen with IL-6 assays, and inexperiments using primary spleen cells or the B cell lines CH12.LX andWEHI-231.2.5 μg/ml of chloroquine is equivalent to <5 μM. Otherinhibitors of NF-κB activation including PDTC and calpain inhibitors Iand II gave similar results to the inhibitors shown. The results shownare representative of those obtained in ten different experiments.

Excessive immune activation by CpG motifs may contribute to thepathogenesis of the autoimmune disease systemic lupus erythematosus,which is associated with elevated levels of circulating hypomethylatedCpG DNA. Chloroquine and related antimalarial compounds are effectivetherapeutic agents for the treatment of systemic lupus erythematosus andsome other autoimmune diseases, although their mechanism of action hasbeen obscure. Our demonstration of the ability of extremely lowconcentrations of chloroquine to specifically inhibit CpG-mediatedleukocyte activation suggests a possible new mechanism for itsbeneficial effect. It is noteworthy that lupus recurrences frequentlyare thought to be triggered by microbial infection. Levels of bDNApresent in infected tissues can be sufficient to induce a localinflammatory response. Together with the likely role of CpG DNA as amediator of the sepsis syndrome and other diseases our studies suggestpossible new therapeutic applications for the antimalarial drugs thatact as inhibitors of endosomal acidification.

CpG-induced ROS generation could be an incidental consequence of cellactivation, or a signal that mediates this activation. The ROS scavengerN-acetyl-L-cysteine (NAC) blocks CpG-induced NFκB activation, cytokineproduction, and B cell proliferation, suggesting a casual role for ROSgeneration in these pathways. These data are compatible with previousevidence supporting a role for ROS in the activation of NFkB. WEHI-231 Bcells (5×10⁵ cells/ml) were precultured for 30 minutes with or withoutchloroquine (5 μg/ml [<10 μM]) or gliotoxin (0.2 μg/ml). Cell aliquotswere then cultured as above for 10 minutes in RPMI medium with orwithout a CpG ODN (1826) or non-CpG ODN (1911) at 1 μM or phorbolmyristate acetate (PMA) plus ionomycin (iono). Cells were then stainedwith dihydrorhodamine-123 and analyzed for intracellular ROS productionby flow cytometry as described (A. K. Krieg, A.-K. Yi, S. Matson, T. J.Waldschmidt, G. A. Bishop, R. Teasdale, G. Koretzky and D. Klinman,Nature 374, 546 (1995); Yi, A.-K., D. M. Klinman, T. L. Martin, S.Matson and A. M. Krieg, J. Immunol., 157, 5394-5402 (1996); Krieg, A. M,J. Lab. Clin. Med., 128, 128-133 (1996)). J1774 cells, a monocytic line,showed similar pH-dependent CpG induced ROS responses. In contrast, CpGDNA did not induce the generation of extracellular ROS, nor anydetectable neutrophil ROS. The concentrations of chloroquine (and thoseused with the other inhibitors of endosomal acidification) preventedacidification of the internalized CpG DNA using fluorescein conjugatedODN as described by Tonkinson, et al., (Nucl. Acids Res. 22, 4268(1994); A. M. Krieg, In: Delivery Strategies for AntisenseOligonucleotide Therapeutics. Editor, S. Akhtar, CRC Press, Inc., pp.177(1995)). At higher concentrations than those required to inhibitendosomal acidification, nonspecific inhibitory effects were observed.Each experiment was performed at least three times with similar results.

While NFκB is known to be an important regulator of gene expression,it's role in the transcriptional response to CpG DNA was uncertain. Todetermine whether this NFκB activation was required for the CpG mediatedinduction of gene expression cells were activated with CpG DNA in thepresence or absence of pyrrolidine dithiocarbamate (PDTC), an inhibitorof IκB phosphorylation. These inhibitors of NFκB activation completelyblocked the CpG-induced expression of protooncogene and cytokine mRNAand protein, demonstrating the essential role of NFκB as a mediator ofthese events. None of the inhibitors reduced cell viability under theexperimental conditions used in these studies. A J774, a murine monocytecell line, was cultured in the presence of calf thymus (CT), E. coli(EC), or methylated E. coli (mEC) DNA (methylated with CpG methylase asdescribed) at 5 μg/ml or a CpG oligodeoxynucleotide (ODN 1826; Table 15)or a non-CpG ODN (ODN 1745; TCCATGAGCTTCCTGAGTCT, SEQ. ID. NO: 8) at0.75 μM for 1 hr, following which the cells were lysed and nuclearextracts prepared. A double stranded ODN containing a consensus NFκBsite was 5′ radiolabeled and used as a probe for EMSA essentially asdescribed (J. D. Dignam, R. M. Lebovitz and R. G. Roeder, Nucleic AcidsRes. 11, 1475 (1983); M. Briskin, M. Damore, R. Law, G. Lee, P. W.Kincade, C. H. Sibley, M. Kuehl and R. Wall, Mol. Cell. Biol. 10, 422(1990)). The position of the p50/p65 heterodimer was determined bysupershifting with specific Ab to p65 and p50 (Santa Cruz Biotechnology,Santa Cruz, Calif.). Chloroquine inhibition of CpG-induced but notLPS-induced NFκB activation was established using J774 cells. The cellswere precultured for 2 hr in the presence or absence of chloroquine (20μg/ml) and then stimulated as above for 1 hr with either EC DNA, CpGODN, non-CpG ODN or LPS (1 μg/ml). Similar chloroquine sensitiveCpG-induced activation of NFkB was seen in a B cell line, WEHI-231 andprimary spleen cells. These experiments were performed three times overa range of chloroquine concentrations form 2.5 to 20 μg/ml with similarresults.

It was also established that CpG-stimulated mRNA expression requiresendosomal acidification and NFkB activation in B cells and monocytes.J774 cells (2×10⁶ cells/ml) were cultured for 2 hr in the presence orabsence of chloroquine (2.5 μg/ml [<5 μM]) or N-tosyl-L-phenylalaninechlorometryl ketone (TPCK: 50 μM), a serine/threonine protease inhibitorthat prevents IκB proteolysis and thus blocks NFkB activation. Cellswere then stimulated with the addition of E. coli DNA (EC: 50 μg/ml),calf thymus DNA (CT: 50 μg/ml), LPS (10 μg/ml), CpG ODN (1826; 1 μM), orcontrol non CpG ODN (1911; 1 μM) for 3 hr. WEHI-231 B cells (5×10⁵cells/ml) were cultured in the presence or absence of gliotoxin (0.1μg/ml) or bisgliotoxin (0.1 μg/ml) for 2 hrs and then stimulated with aCpG ODN (1826), or control non-CpG ODN (1911; TCCAGGACTTTCCTCAGGTT, SEQ.ID. NO. 97) at 0.5 μM for 8 hr. In both cases, cells were harvested andRNA was prepared using RNAzol following the manufacturer's protocol.Multi-probe RNASE protection assay was performed as described (A.-K. Yi,P. Hornbeck, D. E. Lafrenz and A. M. Krieg, J. Immunol., 157, 4918-4925(1996). Comparable amounts of RNA were loaded into each lane by usingribosomal mRNA as a loading control (L32). These experiments wereperformed three times with similar results.

The results indicate that leukocytes respond to CpG DNA through a novelpathway involving the pH-dependent generation of intracellular ROS. ThepH dependent step may be the transport or processing of the CpG DNA, theROS generation, or some other event. ROS are widely thought to be secondmessengers in signaling pathways in diverse cell types, but have notpreviously been shown to mediate a stimulatory signal in B cells.

Presumably, there is a protein in or near the endosomes thatspecifically recognizes DNA containing CpG motifs and leads to thegeneration of reactive oxygen species. To detect any protein in the cellcytoplasm that may specifically bind CpG DNA, electrophoretic mobilityshift assays (EMSA) were used with 5′ radioactively labeledoligonucleotides with or without CpG motifs. A band was found thatappears to represent a protein binding specifically to single strandedoligonucleotides that have CpG motifs, but not to oligonucleotides thatlack CpG motifs or to oligonucleotides in which the CpG motif has beenmethylated. This binding activity is blocked if excess ofoligonucleotides that contain the NFkB binding site was added. Thissuggests that an NFkB or related protein is a component of a protein orprotein complex that binds the stimulatory CpG oligonucleotides.

No activation of CREB/ATF proteins was found at time points where NFkBwas strongly activated. These data therefore do not provide proof theNFkB proteins actually bind to the CpG nucleic acids, but rather thatthe proteins are required in some way for the CpG activity. It ispossible that a CREB/ATF or related protein may interact in some waywith NFkB proteins or other proteins thus explaining the remarkablesimilarity in the binding motifs for CREB proteins and the optimal CpGmotif. It remains possible that the oligos bind to a CREB/ATF or relatedprotein, and that this leads to NFkB activation.

Alternatively, it is very possible that the CpG nucleic acids may bindto one of the TRAF proteins that bind to the cytoplasmic region of CD40and mediate NFkB activation when CD40 is cross-linked. Examples of suchTRAF proteins include TRAF-2 and TRAF-5.

Method for Making Immunostimulatory Nucleic Acids

For use in the instant invention, nucleic acids can be synthesized denovo using any of a number of procedures well known in the art. Forexample, the b-cyanoethyl phosphoramidite method (S. L. Beaucage and M.H. Caruthers, (1981) Tet. Let. 22:1859); nucleoside H-phosphonate method(Garegg et al., (1986) Tet. Let. 27:4051-4054; Froehler et al., (1986)Nucl. Acid. Res 14:5399-5407; Garegg eg al., (1986) Tet. Let.27:4055-4058, Gaffney et al., (1988) Tet. Let. 29:2619-2622). Thesechemistries can be performed by a variety of automated oligonucleotidesynthesizers available in the market. Alternatively, oligonucleotidescan be prepared from existing nucleic acid sequences (e.g. genomic orcDNA) using known techniques, such as those employing restrictionenzymes, exonucleases or endonucleases.

For use in vivo, nucleic acids are preferably relatively resistant todegradation (e.g. via endo- and exo- nucleases). Secondary structures,such as stem loops, can stabilize nucleic acids against degradation.Alternatively, nucleic acid stabilization can be accomplished viaphosphate backbone modifications. A preferred stabilized nucleic acidhas at least a partial phosphorothioate modified backbone.Phosphorothioates may be synthesized using automated techniquesemploying either phosphoramidate or H-phosphonate chemistries. Aryl- andalkyl-phosphonates can be made e.g as described in U.S. Pat. No.4,469,863; and alkylphosphotriesters (in which the charged oxygen moietyis alkylated as described in U.S. Pat. No. 5,023,243 and European PatentNo. 092,574) can be prepared by automated solid phase synthesis usingcommercially available reagents. Methods for making other DNA backbonemodifications and substitutions have been described (Uhlmann, E. AndPeyman, A. (1990) Chem. Rev. 90:544; Goodchild, J. (1990) BioconjugateChem. 1:165). 2′-O-methyl nucleic acids with CpG motifs also causeimmune activation, as do ethoxy-modified CpG nucleic acids. In fact, nobackbone modifications have been found that completely abolish the CpGeffect, although it is greatly reduced by replacing the C with a5-methyl C.

For administration in vivo, nucleic acids may be associated with amolecule that results in higher affinity binding to target cell (e.g.B-cell, monocytic cell and natural killer (NK) cell) surfaces and/orincreased cellular uptake by target cells to form a “nucleic aciddelivery complex”. Nucleic acids can be ionically, or covalentlyassociated with appropriate molecules using techniques which are wellknown in the art. A variety of coupling or crosslinking agents can besued e.g. Protein A, carbodiimide, andN-succinimidyl-3-(2-pyridyldithio) propionate (SPDP). Nucleic acids canalternatively be encapsulated in liposomes or virosomes using well-knowntechniques.

Therapeutic Uses of Immunostimulatory Nucleic Acid Molecules

Based on their immunostimulatory properties, nucleic acid moleculescontaining at least one unmethylated CpG dinucleotide can beadministered to a subject in vivo to treat an “immune systemdeficiency”. Alternatively, nucleic acid molecules containing at leastone unmethylated CpG dinucleotide can be contacted with lymphocytes(e.g. B cells, monocytic cells or NK cells) obtained from a subjecthaving an immune system deficiency ex vivo and activated lymphocytes canthen be re-implanted in the subject.

As reported herein, in response to unmethylated CpG containing nucleicacid molecules, an increased number of spleen cells secrete IL-6, IL-12,IFNγ, IFN-α, IFN-β, IL-1, IL-3, IL-10, TNF-α, TNF-β, GM-CSF, RANTES, andprobably others. The increased IL-6 expression was found to occur in Bcells, CD4⁺T cells and monocytic cells.

Immunostimulatory nucleic acid molecules can also be administered to asubject in conjunction with a vaccine to boost a subject's immune systemand thereby effect a better response from the vaccine. Preferably theimmunostimulatory nucleic acid molecule is administered slightly beforeor at the same time as the vaccine. A conventional adjuvant mayoptionally be administered in conjunction with the vaccine, which isminimally comprised of an antigen, as the conventional adjuvant mayfurther improve the vaccination by enhancing antigen absorption.

When the vaccine is a DNA vaccine at least two components determine itsefficacy. First, the antigen encoded by the vaccine determines thespecificity of the immune response. Second, if the backbone of theplasmid contains CpG motifs, its functions as an adjuvant for thevaccine. Thus, CpG DNA acts as an effective “danger signal” and causesthe immune system to respond vigorously to new antigens in the area.This mode of action presumably results primarily from the stimulatorylocal effects of CpG DNA on dendritic cells and other “professional”antigen presenting cells, as well as from the co-stimulatory effects onB cells.

Immunostimulatory oligonucleotides and unmethylated CpG containingvaccines, which directly activate lymphocytes and co-stimulate anantigen-specific response, are fundamentally different from conventionaladjuvants (e.g aluminum precipates), which are inert when injected aloneand are thought to work through absorbing the antigen and therebypresenting it more effectively to immune cells. Further conventionaladjuvants only work for certain antigens, only induce an antibody(humoral) immune response (Th2), and are very poor at inducing cellularimmune responses (Th1). For many pathogens, the humoral responsecontributes little to protection, and can even be detrimental.

In addition, an immunostimulatory oligonucleotide can be administeredprior to along with or after administration of a chemotherapy orimmunotherapy to increase the responsiveness of the malignant cells tosubsequent chemotherapy or immunotherapy or to speed the recovery of thebone marrow through induction of restorative cytokines such as GM-CSF.CpG nucleic acids also increase natural killer cell lytic activity andantibody dependent cellular cytotoxicity (ADCC). Induction of NKactivity and ADCC may likewise be beneficial in cancer immunotherapy,alone or in conjunction with other treatments.

Another use of the described immunostimulatory nucleic acid molecules isin desensitization therapy for allergies, which are generally caused byIgE antibody generation against harmless allergens. The cytokines thatare induced by unmethylated CpG nucleic acids are predominantly of aclass called “Th1” which is most marked; by a cellular immune responseand is associated with Il-12 and IFN-γ. The other major type of immuneresponse is termed a Th2 immune response, which is associated with moreof an antibody immune response and with the production of IL-4, Il-5 andIL-10. In general, it appears that allergic diseases are mediated by Th2type immune responses and autoimmune diseases by Th1 immune response.Based on the ability of the immunostimulatory nucleic acid molecules toshift the immune response in a subject from a Th2 (which is associatedwith production of IgE antibodies and allergy) to a Th1 response (whichis protective against allergic reactions), an effective dose of animmunostimulatory nucleic acid (or a vector containing a nucleic acid)alone or in conjunction with an allergen can be administered to asubject to treat or prevent an allergy.

Nucleic acids containing unmethylated CpG motifs may also havesignificant therapeutic utility in the treatment of asthma. Th2cytokines, especially IL-4 and IL-5 are elevated in the airways ofasthmatic subjects. These cytokines promote important aspects of theasthmatic inflammatory response, including IgE isotype switching,eosinophil chemotaxis and activation and mast cell growth. Th1cytokines, especially IFN-γ and IL-12, can suppress the formation of Th2clones and production of Th2 cytokines.

As described in detail in the following Example 12, oligonucleotidescontaining an unmethylated CpG motif (I, e,. TCCATGACGTTCCTGACGTT; SEQID NO. 10) but not a control oligonucleotide (TCCATGAGCTTCCTGAGTCT; SEQID NO. 8) prevented the development of an inflammatory cellularinfiltrate and eosinophilia in a murine model of asthma. Furthermore,the suppression of eosinophilic inflammation was associated with asuppression of a Th2 response and induction of a Th1 response.

For use in therapy, an effective amount of an appropriateimmunostimulatory nucleic acid molecule alone or formulated as adelivery complex can be administered to a subject by any mode allowingthe oligonucleotide to be taken up by the appropriate target cells(e.g., B-cells and monocytic cells). Preferred routes of administrationinclude oral and transdermal (e.g., via a patch). Examples of otherroutes of administration include injection (subcutaneous, intravenous,parenteral, intraperitoneal, intrathecal, etc.). The injection can be ina bolus or a continuous infusion.

A nucleic acid alone or as a nucleic acid delivery complex can beadministered in conjunction with a pharmaceutically acceptable carrier.As used herein, the phrase “pharmaceutically acceptable carrier” isintended to include substances that can be coadministered with a nucleicacid or a nucleic acid delivery complex and allows the nucleic acid toperform its indicated function. Examples of such carriers includesolutions, solvents, dispersion media, delay agents, emulsions and thelike. The use of such media for pharmaceutically active substances arewell known in the art. Any other conventional carrier suitable for usewith the nucleic acids falls within the scope of the instant invention.

The term “effective amount” of a nucleic acid molecule refers to theamount necessary or sufficient to realize a desired biologic effect. Forexample, an effective amount of a nucleic acid containing at least oneunmethylated CpG for treating an immune system deficiency could be thatamount necessary to eliminate a tumor, cancer, or bacterial, viral orfungal infection. An effective amount for use as a vaccine adjuvantcould be the amount useful for boosting a subjects immune response to avaccine. An “effective amount” for treating asthma can be that amount;useful for redirecting a Th2 type of immune response that is associatedwith asthma to a Th1 type of response. The effective amount for anyparticular application can vary depending on such factors as the diseaseor condition being treated, the particular nucleic acid beingadministered (e.g the number of unmethylated CpG motifs or theirlocation in the nucleic acid), the size of the subject, or the severityof the disease or condition. One of ordinary skill in the art canempirically determine the effective amount of a particularoligonucleotide without necessitating undue experimentation.

The present invention is further illustrated by the following Examples,which in no way should be construed as further limiting. The entirecontents of all of the references (including literature references,issued patents, published patent applications, and co-pending patentapplications) cited throughout this application are hereby expresslyincorporated by reference.

EXAMPLES Example 1 Effects of ODNs on B Cell Total RNA Synthesis andCell Cycle

B cells were purified from spleens obtained from 6-12 week old specificpathogen free DBA/2 or BXSB mice (bred in the University of Iowa animalcare facility; no substantial strain differences were noted) that weredepleted of T cells with anti-Thy-1.2 and complement and centrifugationover lymphocyte M(Cedarlane Laboratories, Homby, Ontario, Canada) (“Bcells”). B cells contained fewer than 1% CD4′ or CD8⁺ cells. 8×10⁴Bcells were dispensed in triplicate into 96 well microtiter plates in 100μl RPMI containing 10% FBS (heat inactivated to 65° C. for 30 min.), 50μM 2-mercaptoethanol, 100 U/ml penicillin, 100 ug/ml streptomycin, and 2mM L-glutamate. 20 μM ODN were added at the start of culture for 20 h at37° C., cells pulsed with 1 μCi of ³H uridine, and harvested and counted4 hr later. Ig secreting B cells were enumerated using the ALISA spotassay after culture of whole spleen cells with ODN at 20 μM for 48 hr.Data, reported in Table 1, represents the stimulation index compared tocell cultured without ODN. ³H thymidine incorporation assays showedsimilar results, but with some nonspecific inhibition by thymidinereleased from degraded ODN (Matson. S and A. M. Krieg (1992) Nonspecificsuppression of ³H-thymidine incorporation by control oligonucleotides.Antisense Research and Development 2:325).

Example 2 Effects of ODN on Production of IgM from B Cells

Single cell suspensions form the spleens of freshly killed mice weretreated with anti-Thyl, anti-CD4, and anti-CD8 and complement by themethod of Leibson et al., J. Exp. Med. 154:1681 (1981)). Resting B cells(<02% T cell contamination) were isolated from the 63-70% band of adiscontinuous Percoll gradient by the procedure of DeFranco et al, J.Exp. Med. 155:1523 (1982). These were cultured as described above in 30μg/ml LPS for 48 hr. The number of B cells actively secreting IgM wasmaximal at this time point, as determined by ELIspot assay (Klinman, D.M. et al. J. Immunol 144:506 (1990)). In that assay, B cells wereincubated for 6 hrs on anti-Ig coated microtiter plates. The Ig theyproduced (>99% IgM) was detected using phosphatase-labeled anti-Ig(Southern Biotechnology Associated, Birmingham, Ala.). The antibodiesproduced by individual B cells were visualized by addition of BCIP(Sigma Chemical Co., St. Louis Mo.) which forms an insoluble blueprecipitate in the presence of phosphatase. The dilution of cellsproducing 20-40 spots/well was used to determine the total number ofantibody-secreting B cells/sample. All assays were performed intriplicate (data reported in Table 1). In some experiments, culturesupernatants were assayed for IgM by ELISA, and showed similar increasedin response to CpG-ODN.

Example 3 B Cell Stimulation by Bacterial DNA

DBA/2 B cells were cultured with no DNA or 50 μg/ml of a (Micrococcuslysodeikticus; b) NZB/N mouse spleen; and c) NSF/N mouse spleen genomicDNAs for 48 hours, then pulsed with ³H thymidine for 4 hours prior tocell harvest. Duplicate DNA samples were digested with DNASE I for 30minutes at 37° C. prior to addition to cell cultures. E coli DNA alsoinduced an 8.8 fold increase in the number of IgM secreting B cells by48 hours using the ELISA spot assay.

DBA/2 B cells were cultured with either no additive, 50 μg/ml LPS or theODN 1; 1a; 4; or 4a at 20 uM. Cells were cultured and harvested at 4, 8,24 and 48 hours. BXSB cells were cultured as in Example 1 with 5, 10,20, 40 or 80 μM of ODN 1; 1a; 4; or 4a or LPS. In this experiment, wellswith no ODN had 3833 cpm. Each experiment was performed at least threetimes with similar results. Standard deviations of the triplicate wellswere <5%.

Example 4 Effects of ODN on Natural Killer (NK) Activity

10×10⁶ C57BL/6 spleen cells were cultured in two ml RPMI (supplementedas described for Example 1) with or without 40 μM CpG or non-CpG ODN forforty-eight hours. Cells were washed, and then used as effector cells ina short term ⁵¹Cr release assay with YAC-1 and 2C11, two NK sensitivetarget cell lines (Ballas, Z. K. et al. (1993) j. IMMUNOL. 150:17).Effector cells were added at various concentrations to 10⁴ ⁵¹Cr-labeledtarget cells in V-bottom microtiter plates in 0.2 ml, and incubated in5% CO₂ for 4 hr. At 37° C. Plates were then centrifuged, and an aliquotof the supernatant counted for radioactivity. Percent specific lysis wasdetermined by calculating the ratio of the ⁵¹Cr released in the presenceof effector cells minus the ⁵¹Cr released when the target cells arecultured alone, over the total counts released after cell lysis in 2%acetic acid minus the ⁵¹Cr cpm released when the cells are culturedalone.

Example 5 In vivo Studies with CVG Phosphorothioate ODN

Mice were weighted and injected 1P with 0.25 ml of sterile PBS or theindicated phosphorothioate ODN dissolved in PBS. Twenty four hourslater, spleen cells were harvested, washed, and stained for flowcytometry using phycoerythrin conjugated 6B2 to gate on B cells inconjunction with biotin conjugated anti Ly-6A/E or anti-Ia^(d)(Pharmingen, San Diego, Calif.) or anti-Bla-1 (Hardy, R. R. et al., J.Exp. Med 159:1169 (1984). Two mice were studied for each condition andanalyzed individually.

Example 6 Titration of Phosphorothioate ODN for B Cell Stimulation

B cells were cultured with phosphorothioate ODN with the sequence ofcontrol ODN 1a or the CpG ODN 1d and 3Db and then either pulsed after 20hr with ³H uridine or after 44 hr with ³H thymidine before harvestingand determining cpm.

Example 7 Rescue of B Cells from Apoptosis

WEHI-231 cells (5×10⁴/well) were cultured for 1 hr. At 37° C. in thepresence or absence of LPS or the control ODN 1a or the CpG ODN 1d and3Db before addition of anti-IgM (1 μ/ml). Cells were cultured for afurther 20 hr. Before a 4 hr. Pulse with 2 μCi/well ³H thymidine. Inthis experiment, cells with no ODN or anti-IgM gave 90.4×10³ cpm of ³Hthymidine incorporation by addition of anti-IgM. The phosphodiester ODNshown in Table 1 gave similar protection, though some nonspecificsuppression due to ODN degradation. Each experiment was repeated atleast 3 times with similar results.

Example 8 In vivo Induction of Murine IL-6

DBA/2 female mice (2 mos. old) were injected IP with 500 g CpG orcontrol phosphorothioate ODN. At various time points after injection,the mice were bled. Two mice were studied for each time point. IL-6 wasmeasured by Elisa, and IL-6 concentration was calculated by comparisonto a standard curve generate using recombinant IL-6. The sensitivity ofthe assay was 10 pg/ml. Levels were undetectable after 8 hrs.

Example 9 Systemic Induction of Murine IL-6 Transcription

Mice and cell lines. DBA/2, BALB/c, and C3H/HeJ mice at 5-10 wk of agewere used as a source of lymphocytes. All mice were obtained from TheJackson Laboratory (Bar Harbor, Me.), and bred and maintained underspecific pathogen-free conditions in the University of Iowa Animal CareUnit. The mouse B cell line CH12.LX was kindly provided by Dr. G. Bishop(University of Iowa, Iowa City).

Cell preparation. Mice were killed by cervical dislocation. Single cellsuspensions were prepared aseptically from the spleens from mice. T celldepleted mouse splenocytes were prepared by using anti-Thy-1.2 andcomplement and centrifugation over lymphocyte M (Cedarlane Laboratories,Hornby, Ontario, Canada) as described (Krieg, A. M. et al., (1989) Arole for endogenous retroviral sequences in the regulation of lymphocyteactivation. J. Immunol 143:2448).

ODN and DNA. Phosphodiester oligonucleotides (O—ODN) and the backbonemodified phosphorothioate oligonucleotides (S—ODN) were obtained fromthe DNA Core facility at the University of Iowa or from OperonTechnologies (Alameda, Calif.). E. coli DNA (Strain B) and calf thymusDNA were purchased from Sigma (St. Louis, Mo.). All DNA and ODN werepurified by extraction with phenol:chloroform:isoamyl alcohol (25:24:1)and/or ethanol precipitation. E. coli and calf thymus DNA were singlestranded prior to use by boiling for 10 min. followed by cooling on icefor 5 min. For some experiments, E. coli and calf thymus DNA weredigested with DNase 1(2U/ug of DNA) at 37° C. for 2 hr in 1×SSC with 5mM MgC12. To methylate the cytosine in CpG dinucleotide in E. coli DNA,E. coli DNA was treated with CpG methylase (M. SssI; 2U/μg of DNA) inNEBuffer 2 supplemented with 160 μM S-adenosyl methionine and incubatedovernight at 37° C. Methylated DNA was purified as above. Efficiency ofmethylation was confirmed by Hpa II digestion followed by analysis bygel electrophoresis. All enzymes were purchased from New England Biolabs(Beverly, Mass.). LPS level in ODN was less than 12.5 ng/mg and E. coliand calf thymus DNA contained less than 2.5 ng of LPS/mg of DNA byLimulus assay.

Cell Culture. All cells were cultured at 37° C. in a 5% CO₂ humidifierincubator maintained in RPMI-1640 supplemented with 10% (v/v) heatinactivated fetal calf serum (FCS), 1.5 mM L-glutamine, 50 μ/ml), CpG ornon-CpG phosphodiester ODN (O—ODN) (20 μM), phosphorothioate ODN (S—ODN)(0.5 μM), or E. coli or calf thymus DNA (50 μg/ml) at 37° C. for 24 hr.(for IL-6 production) or 5 days (for IgM production). Concentrations ofstimulants were chosen based on preliminary studies with titrations. Insome cases, cells were treated with CpG O—ODN along with variousconcentrations (1-10 μg/ml) of neutralizing rat IgGl antibody againstmurine IL-6 (hybridoma MP5-20F3) or control rat IgGl mAB to E. colib-galactosidase (hybridoma GL 113; ATCC, Rockville, Md.) (20) for 5days. At the end of incubation, culture supernatant fractions wereanalyzed by ELISA as below.

In vivo induction of IL-6 and IgM BALB/c mice were injectedintravenously (iv) with PBS, calf thymus DNA (200 μg/100 μl PBS/mouse),E. coli DNA (200 μg/100 μl PBS/mouse), or CpG or non-CpG S—ODN (200μg/100 μl PBS/mouse). Mice (two/group) were bled by retroorbitalpuncture and sacrificed by cervical dislocation at various time points.Liver, spleen, thymus, and bone marrow were removed by RNA was preparedfrom those organs using RNAzol B (Tel-Test, Friendswood, Tex.) accordingto the manufactures protocol.

ELISA. Flat-bottomed Immun 1 plates (Dynatech Laboratories, Inc.,Chantilly, Va.) were coated with 100 μl/well of anti-mouse IL-6 mAb(MP5-20F3) (2 μg/ml) or anti-mouse IgM μ-chain specific (5 μg/ml; Sigma,St. Louis, Mo.) in carbonate-bicarbonate, pH 9.6 buffer (15 nM Na₂CO₃,35 mM NaHCO₃) overnight at 4° C. The plates were then washed with TPBS(0.5 mM MgCl₂06H₂0, 2.68 mM KCl, 1.47 mM KH₂PO₄, 0.14 M NaCl, 6.6 mMK₂HPO₄, 0.5% Tween 20) and blocked with 10% FCS and TPBS for 2 hr atroom temperature and then washed again. Culture supernatants, mousesera, recombinant mouse IL-6 (Pharmigen, San Diego, Calif.) or purifiedmouse IgM (Calbiochem, San Diego, Calif.) were appropriately diluted in10% FCS and incubated in triplicate wells for 6 hr at room temperature.The plates were washed and 100 μl/well of biotinylated rat anti-mouseIL-6 monoclonal antibodies (MP5-32C11, Pharmingen, San Diego, Calif.) (1μg/ml in 10% FCS) or biotinylated anti-mouse Ig (Sigma, St. Louis, Mo.)were added and incubated for 45 min. at room temperature followingwashes with TPBS. Horseradish peroxidase (HRP) conjugated avidin(Bio-rad Laboratories, Hercules, Calif.) at 1:4000 dilution in 10% FCS(100 μl/well) was added and incubated at room temperature for 30 min.The plates were washed and developed with o-phenylenediaminedihydrochloride (OPD; Sigma, St. Louis Mo.) 0.05 M phosphate-citratebuffer, pH 5.0, for 30 min. The reaction was stopped with 0.67 N H₂SO₄and plates were read on a microplate reader (Cambridge Technology, Inc.,Watertown, Mass.) at 490-600 nm. The results are shown in FIGS. 1 and 2.

RT-PCR A sense primer, an antisense primer, and an internaloligonucleotide probe for IL-6 were synthesized using publishedsequences (Montgomery, R. A. and M. S. Dallman (1991), Analysis forcytokine gene expression during fetal thymic ontogeny using thepolymerase chain reaction (J. Immunol.) 147:554). cDNA synthesis andIL-6 PCR was done essentially as described by Montgomery and Dallman(Montgomery, R. A. And M. S. Dallman (1991), Analysis of cytokine geneexpression during fetal thymic ontogeny using the polymerase chainreaction (J. Immunol.) 147:554) using RT-PCR reagents from Perkin-ElmerCorp. (Hayward, Calif.). Samples were analyzed after 30 cycles ofamplification by gel electrophoresis followed by unblot analysis (stoye,J. P. et al., (1991) DNA hybridization in dried gels with fragmentedprobes: an improvement over blotting techniques, Techniques3: 123).Briefly, the gel was hybridized at room temperature for 30 min. indenaturation buffer (0.05 M NaOH, 1.5M NaCl) followed by incubation for30 min. In renaturation buffer (1.5 M NaCl, 1 M Tris, pH 8) and a 30min. Wash in double distilled water. The gel was dried and prehybridizedat 47° C. for 2 hr. Hybridization buffer (5×SSPE, 0.1% SDS) containing10 μg/ml denatured salmon sperm DNA. The gel was hybridized with 2×10⁶cpm/ml g-[³² P] ATP end-labeled internal oligonucleotide probe for IL-6(5′CATTTCCGATTTCCCA3′) SEQ ID. NO: 118) overnight at 47° C., washed 4times (2×SSC, 0.2% SDS) at room temperature and autoradiographed. Theresults are shown in FIG. 3.

Cell Proliferation assay. DBA/2 mice spleen B cells (5×10⁴ cells/100μl/well) were treated with media, CpG or non-CpG S—ODN (0.5 μM) or O—ODN(20 μM) for 24 hr at 37° C. Cells were pulsed for the last four hr. Witheither [³H] Thymidine or [³H] Uridine (1 μCi/well). Amounts of [³H]incorporated were measured using Liquid Scintillation Analyzer (PackardInstrument Co., Downers Grove, Ill.).

Transfections and CAT assays. WEHI-231 cells (10⁷ cells) wereelectroporated with 20 μg of control or human IL-6 promoter-CATconstruct (kindly provided by S. Manolagas, Univ. of Arkansas)(Pottratz, S. T. Et. al., (1994) 17B-estradiol inhibits expression ofhuman interleukin-6 promotor-reporter constructs by a receptor-dependentmechanism. J. Clin. Invest. 93:944) at 250 mV and 960 μF. Cells werestimulated with various concentrations of CpG or non-CpG ODN afterelectroporation. Chloramphenicol acetyltransferase (CAT) activity wasmeasured by a solution assay (Seed, B. and J. Y. Sheen (1988) A singlephase-extraction assay for chloramphenicol acetyl transferase activity.Gene 76:271) 16 hr. after transfection. The results are presented inFIG. 5.

Example 10 Oligodeoxynucleotide Modifications Determine the Magnitude ofB Cell Stimulation by CpG Motifs

ODN were synthesized on an Applied Biosystems Inc. (Foster City, Calif.)model 380A, 380B, or 394 DNA synthesizer using standard procedures(Beacage and Caruthers (1981) Deoxynucleoside phosphoramidites—A newclass of key intermediates for deoxypolynucleotide synthesis. TetrahedonLetters 22, 1859-1862.). Phosphodiester ODN were synthesized usingstandard beta-cyanoethyl phosphoramidite chemistry. Phosphorothioatelinkages were introduced by oxidizing the phosphite linkage withelemental sulfur instead of the standard iodine oxidation. The fourcommon nucleoside phosphoramidites were purchased from AppliedBiosystems. All phosphodiester and thioate containing ODN were protectedby treatment with concentrated ammonia at 55° C. for 12 hours. The ODNwere purified by gel exclusion chromatography and lyophilized to drynessprior to use. Phosphorodithioate linkages were introduced by usingdeoxynucleoside S-(b-benzoylmercaptoethyl) pyrrolidinothiophosphoramidites (Wiesler, W. T. et al.,(1993) In Methods inMolecular Biology: Protocols for Oligonucleotides and Analogs—Synthesisand Properties, Agrawal, S. (Ed.), Humana Press, 191-206.). Dithioatecontaining ODN were deprotected by treatment with concentrated ammoniaat 55° C. for 12 hours followed by reverse phase HPLC purification.

In order to synthesize oligomers containing methylphosphonothioates ormethylphosphonates as well as phosphodiesters at any desiredinternucleotide linkage, two different synthetic cycles were used. Themajor synthetic differences in two cycles are the coupling reagent wheredialkylaminomethylnucleoside phosphines are used and the oxidationreagents in the case of methylphosphonothioates. In order to synthesizeeither derivative, the condensation time has been increased for thedialkylaminomethylnucleoside phosphines due to the slower kinetics ofcoupling (Jager and Engels, (1984) Synthesis of deoxynucleosidemethylphosphonates via a phosphonamidite approach. Tetrahedron Letters24, 1437-1440). After the coupling step has been completed, themethylphosphnodiester is treated with the suflfurizing reagent (5%elemental sulfur, 100 millimolar N,N-diamethylaminopyridine in carbondisulfide/pyridine/triethylamine), four consecutive times for 450seconds each to produce methylphosphonothioates. To producemethylphosphonate linkages, the methylphosphinodiester is treated withstandard oxidizing reagent (0.1 M iodine intetrahydrofuran/2,6-lutidine/water).

The silica gel bound oligomer was treated with distilledpyridine/concentrated ammonia, 1:1, (v/v) for four days at 4 degreescentigrade. The supernatant was dried in vacuo, dissolved in water andchromatographed on a G50/50 Sephadex column.

As used herein, O—ODN refers to ODN which are phosphodiester; S—ODN arecompletely phosphorothioate modified; S—O═ODN are chimeric ODN in whichthe central linkages are phosphodiester, but the two 5′ and five 3′linkages are phosphorothioate modified; 2₂—O—ODN are chimeric ODN inwhich the central linkages are phosphodiester, but the two 5′ and five3′ linkages are phosphorodithioate modified; and MP—O—ODN are chimericODN in which the central linkages are phosphodiester, but the two 5′ andfive 3′ linkages are methylphosphonate modified. The ODN sequencesstudied (with CpG dinucleotides indicated by underlining) include:

3D (5″ GAGAACGCTGGACCTTCCAT), (SEQ. ID. NO. 20);

3M (5′ TCCATGTCGGTCCTGATGCT), (SEQ. ID. NO. 28);

5 (5′ GGCGTTATTCCTGACTCGCC), (SEQ. ID. NO. 99); and

6 (5′ CCTACGTTGTATGCGCCCAGCT), (SEQ. ID NO. 100).

These sequences are representative of literally hundreds of CpG andnon-CpG ODN that have been tested in the course of these studies.

Mice. DBA/2, or BXSB mice obtained from The Jackson Laboratory (BarHarbor, Me.), and maintained under specific pathogen-free conditionswere used as a source of lymphocytes at 5-10 wk of age with essentiallyidentical results.

Cell proliferation assay. For cell proliferation assays, mouse spleencells (5×10⁴ cells/100 μl/well) were cultured at 37° C. in a 5% CO₂humidified incubator in RPMI-1640 supplemented with 10% (v/v) heatinactivated fetal calf serum (heated to 65° C. for experiments withO—ODN, or 56° C. for experiments using only modified ODN), 1.5 μML-glutamine, 50 μM 2-mercaptoethanol, 100 U/ml penicillin and 100 μg/mlstreptomycin for 24 hr or 48 hr as indicated. 1 μCi of ³H uridine orthymidine (as indicated) was added to each well, and the cells harvestedafter an additional 4 hours of culture. Filters were counted byscintillation counting. Standard deviations of the triplicate wells were<5%. The results are presented in FIGS. 6-8.

Example 11 Induction of NK Activity

Phosphodiester ODN were purchased form Operon Technologies (Alameda,Calif.). Phosphorothioate ODN were purchased from the DNA core facility,University of Iowa, or from The Midland Certified Reagent Company(Midland Tex.). E. coli (strain B) DNA and calf thymus DNA werepurchased from Sigma (St. Louis, Mo.). All DNA and ODN were purified byextraction with phenol:chloroform:isoamyl alcohol (25:24: 1) and/orethanol precipitation. The LPS level in ODN was less than 12.5 ng/mg andE. coli and calf thymus DNA contained less than 2.5 ng of LPS/mg of DNAby Limulus assay.

Virus-free, 4-6 week old, DBA/2, C57BL/6 (B6) and congenitally thymicBALB/C mice were obtained on contract through the Veterans Affairs fromthe National Cancer Institute (Bethesda, Md.). C57BL/6 SCID mice werebred in the SPF barrier facility at the University of Iowa Animal CareUnit.

Human peripheral monucluclear blood leukocytes (PBMC) were obtained aspreviously described (Ballas, Z. K. et al., (1990) J. Allergy Clin.Immunol. 85:453; Ballas, Z. K. And W. Rasmussen (1990) J. Immunol.145:1039; Ballas, Z. K. and W. Rasmussen (1993) J. Immunol. 150;17).Human or murine cells were cultured at 5×10⁶/well, at 37° C. in a 5% CO₂humidified atmosphere in 24-well plates (Ballas, Z. K. Et al., (1990) J.Allergy Clin. Immunol. 85:453; Ballas, Z. K. And W. Rasmussen (1990) J.Immunol 145:1039; and Ballas, Z. K. and W. Rasmussen (1193) J. Immunol,150:17), with medium alone or with CpG or non-CpG ODN at the indicatedconcentrations, or with E. coli or calf thymus (50 μg/ml) at 37° C. for24 hr. All cultures were harvested at 18 hr. and the cells were used aseffectors in a standard 4 hr. ⁵¹Cr-release assay against K562 (human) orYAC-1 (mouse) target cells as previously described. For calculation oflytic units (LU), 1 LU was defined as the number of cells needed toeffect 30% specific lysis. Where indicated, neutralizing antibodiesagainst IFN-β (Lee Biomolecular, San Diego, Calif.) or IL-12 (C15.1,C15.6, C17.8, and C17.15; provided by Dr. Giorgio Trinchieri, TheWinstar Institute, Philadelphia, Pa.) or their isotype controls wereadded at the initiation of cultures to a concentration of 10 μg/ml. Foranti-IL-12 additional, 10 μg of each of the 4 MAB (or isotype controls)were added simultaneously. Recombinant human IL-2 was used at aconcentration of 100 U/ml.

Example 12 Prevention of the Development of an Inflammatory Cellular

Infiltrate and Eosinophilia in a Murine Model of Asthma

6-8 week old C56BL/6 mice (from The Jackson Laboratory, Bar Harbor, Me.)were immunized with 5,000 Schistosoma mansoni eggs by intraperitoneal(i.p.) injection on days 0 and 7. Schistosoma mansoni eggs contain anantigen (Schistosoma mansoni egg antigen (SEA)) that induces a Th2immune response (e.g. production of IgE antibody). IgE antibodyproduction is known to be an important cause of asthma.

The immunized mice were then treated with oligonucleotides (30 μg in 200μl saline by i.p. injection), which either contained an unmethylated CpGmotif (i e., TCCATGACGTTCCTGACGTT; SEQ ID NO.10) or did the (i.e.,control, TCCATGAGCTTCCTGAGTCT; SEQ ID NO. 8). Soluble SeEA (10 μg in 25μl of saline) was administered by intranasal instillation on days 14 and21. Saline was used as a control.

Mice were sacrificed at various times after airway challenge. Whole lunglavage was performed to harvest airway and alveolar inflammatory cells.Cytokine levels were measured from lavage fluid by ELISA. RNA wasisolated from whole lung for Northern analysis and RT-PCR studies usingCsCl gradients. Lungs were inflated and perfused with 4%paraformaldehyde for histologic examination.

FIG. 9 shows that when the mice are initially injected with the eggsi.p., and then inhale the egg antigen (open circle), many inflammatorycells are present in the lungs. However, when the mice are initiallygiven a nucleic acid containing an unmethylated CpG motif along with theeggs, the inflammatory cells in the lung are not increased by subsequentinhalation of the egg antigen (open triangles).

FIG. 10 shows that the same results are obtained only when eosinophilspresent in the lung lavage are measured. Eosinophils are the type ofinflammatory cell most closely associated with asthma.

FIG. 11 shows that when the mice are treated with a control oligo at thetime of the initial exposure to the egg, there is little effect on thesubsequent influx of eosinophils into the lungs after inhalation of SEA.Thus, when mice inhale the eggs on days 14 or 21, they develop an acuteinflammatory response in the lungs. However, giving a CpG oligo alongwith the eggs at the time of initial antigen exposure on days 0 and 7almost completely abolishes the increase in eosinophils when the miceinhale the egg antigen on day 14.

FIG. 12 shows that very low doses of oligonucleotide (<10 μg) can givethis protection.

FIG. 13 shows that the resultant inflammatory response correlates withthe levels of the Th2 cytokine IL-4 in the lung.

FIG. 14 shows that administration of an oligonucleotide containing anunmethylated CpG motif can actually redirect the cytokine response ofthe lung to production of II-12, indicating the Th1 type of immuneresponse.

FIG. 15 shows that administration of an oligonucleotide containing anunmethylated CpG motif can also redirect the cytokine response of thelung to production of IFN-γ, indicating a Th1 type of immune response.

Example 13 CpG Oligonucleotides Induce Human PBMC to Secrete Cytokines

Human PBMC were prepared from whole blood by standard centrifugationover Ficoll hypaque. Cells (5×10⁵/ml) were cultured in 10% autologousserum in 95 well microtiter plates with CpG or controloligodeoxynucleotides (24 μg/ml for phosphodiester oligonucleotides; 6g/ml for nuclease resistant phosphorothioate oligonucleotides) for 4 hrin the case of TNF-α or 24 hr. For the other cytokines beforesupernatant harvest and assay, measured by ELISA using Quantikine kitsor reagents from R&D Systems (pg/ml) or cytokine ELISA kits fromBiosource (for IL-12 assay). Assays were performed as per themanufacturer's instructions. Data are presented in Table 6 as the levelof cytokine above that in wells with no added oligodeoxynucleotide.

Those skilled in the art will recognize, or be able to ascertain usingno more than routine experimentation, many equivalents of the specificembodiments of the invention described herein. Such equivalents areintended to be encompassed by the following claims.

123 1 20 DNA Artificial Sequence Synthetic Oligonucleotide 1 atggaaggtccagcgttctc 20 2 20 DNA Artificial Sequence Synthetic Oligonucleotide 2atcgacctac gtgcgttctc 20 3 20 DNA Artificial Sequence SyntheticOligonucleotide 3 tccataacgt tcctgatgct 20 4 15 DNA Artificial SequenceSynthetic Oligonucleotide 4 gctagatgtt agcgt 15 5 19 DNA ArtificialSequence Synthetic Oligonucleotide 5 gagaacgtcg accttcgat 19 6 15 DNAArtificial Sequence Synthetic Oligonucleotide 6 gcatgacgtt gagct 15 7 20DNA Artificial Sequence Synthetic Oligonucleotide 7 tccatgacgttcctgatgct 20 8 20 DNA Artificial Sequence Synthetic Oligonucleotide 8tccatgagct tcctgagtct 20 9 20 DNA Artificial Sequence SyntheticOligonucleotide 9 tccaagacgt tcctgatgct 20 10 20 DNA Artificial SequenceSynthetic Oligonucleotide 10 tccatgacgt tcctgacgtt 20 11 21 DNAArtificial Sequence Synthetic Oligonucleotide 11 tccatgagct tcctgagtgc t21 12 20 DNA Artificial Sequence Synthetic Oligonucleotide 12 ggggtcaacgttgagggggg 20 13 15 DNA Artificial Sequence Synthetic Oligonucleotide 13gctagangtt agcgt 15 14 15 DNA Artificial Sequence SyntheticOligonucleotide 14 gctagacgtt agngt 15 15 20 DNA Artificial SequenceSynthetic Oligonucleotide 15 atcgactctc gagcgttctc 20 16 20 DNAArtificial Sequence Synthetic Oligonucleotide 16 atngactctn gagngttctc20 17 20 DNA Artificial Sequence Synthetic Oligonucleotide 17 atngactctcgagcgttctc 20 18 20 DNA Artificial Sequence Synthetic Oligonucleotide 18atcgactctc gagcgttntc 20 19 20 DNA Artificial Sequence SyntheticOligonucleotide 19 atggaaggtc caacgttctc 20 20 20 DNA ArtificialSequence Synthetic Oligonucleotide 20 gagaacgctg gaccttccat 20 21 20 DNAArtificial Sequence Synthetic Oligonucleotide 21 gagaacgctc gaccttccat20 22 20 DNA Artificial Sequence Synthetic Oligonucleotide 22 gagaacgctcgaccttcgat 20 23 20 DNA Artificial Sequence Synthetic Oligonucleotide 23gagcaagctg gaccttccat 20 24 20 DNA Artificial Sequence SyntheticOligonucleotide 24 gagaangctg gaccttccat 20 25 20 DNA ArtificialSequence Synthetic Oligonucleotide 25 gagaacgctg gacnttccat 20 26 20 DNAArtificial Sequence Synthetic Oligonucleotide 26 gagaacgatg gaccttccat20 27 20 DNA Artificial Sequence Synthetic Oligonucleotide 27 gagaacgctccagcactgat 20 28 20 DNA Artificial Sequence Synthetic Oligonucleotide 28tccatgtcgg tcctgatgct 20 29 20 DNA Artificial Sequence SyntheticOligonucleotide 29 tccatgctgg tcctgatgct 20 30 20 DNA ArtificialSequence Synthetic Oligonucleotide 30 tccatgtngg tcctgatgct 20 31 20 DNAArtificial Sequence Synthetic Oligonucleotide 31 tccatgtcgg tnctgatgct20 32 20 DNA Artificial Sequence Synthetic Oligonucleotide 32 tccatgtcggtcctgctgat 20 33 20 DNA Artificial Sequence Synthetic Oligonucleotide 33tccatgccgg tcctgatgct 20 34 20 DNA Artificial Sequence SyntheticOligonucleotide 34 tccatggcgg tcctgatgct 20 35 20 DNA ArtificialSequence Synthetic Oligonucleotide 35 tccatgacgg tcctgatgct 20 36 20 DNAArtificial Sequence Synthetic Oligonucleotide 36 tccatgtcga tcctgatgct20 37 20 DNA Artificial Sequence Synthetic Oligonucleotide 37 tccatgtcgctcctgatgct 20 38 20 DNA Artificial Sequence Synthetic Oligonucleotide 38tccatgtcgt tcctgatgct 20 39 20 DNA Artificial Sequence SyntheticOligonucleotide 39 tccatgacgt ccctgatgct 20 40 20 DNA ArtificialSequence Synthetic Oligonucleotide 40 tccatcacgt gcctgatgct 20 41 19 DNAArtificial Sequence Synthetic Oligonucleotide 41 ggggtcagtc ttgacgggg 1942 15 DNA Artificial Sequence Synthetic Oligonucleotide 42 gctagacgttagtgt 15 43 15 DNA Artificial Sequence Synthetic Oligonucleotide 43gctagacntt agtgt 15 44 20 DNA Artificial Sequence SyntheticOligonucleotide 44 tccatgtngt tcctgatgct 20 45 18 DNA ArtificialSequence Synthetic Oligonucleotide 45 tctcccagcg tgcgccat 18 46 24 DNAArtificial Sequence Synthetic Oligonucleotide 46 tcgtcgtttt gtcgttttgtcgtt 24 47 20 DNA Artificial Sequence Synthetic Oligonucleotide 47tcgtcgttgt cgttgtcgtt 20 48 21 DNA Artificial Sequence SyntheticOligonucleotide 48 tgtcgtttgt cgtttgtcgt t 21 49 22 DNA ArtificialSequence Synthetic Oligonucleotide 49 tcgtcgttgt cgttttgtcg tt 22 50 19DNA Artificial Sequence Synthetic Oligonucleotide 50 tgtcgttgtcgttgtcgtt 19 51 14 DNA Artificial Sequence Synthetic Oligonucleotide 51tcgtcgtcgt cgtt 14 52 20 DNA Artificial Sequence SyntheticOligonucleotide 52 tcctgtcgtt ccttgtcgtt 20 53 20 DNA ArtificialSequence Synthetic Oligonucleotide 53 tcctgtcgtt ttttgtcgtt 20 54 21 DNAArtificial Sequence Synthetic Oligonucleotide 54 tcgtcgctgt ctgcccttct t21 55 21 DNA Artificial Sequence Synthetic Oligonucleotide 55 tcgtcgctgttgtcgtttct t 21 56 21 DNA Artificial Sequence Synthetic Oligonucleotide56 gcgtgcgttg tcgttgtcgt t 21 57 6 DNA Artificial Sequence SyntheticOligonucleotide 57 gtcgtt 6 58 6 DNA Artificial Sequence SyntheticOligonucleotide 58 gtcgct 6 59 24 DNA Artificial Sequence SyntheticOligonucleotide 59 accatggacg atctgtttcc cctc 24 60 18 DNA ArtificialSequence Synthetic Oligonucleotide 60 taccgcgtgc gaccctct 18 61 24 DNAArtificial Sequence Synthetic Oligonucleotide 61 accatggacg aactgtttcccctc 24 62 24 DNA Artificial Sequence Synthetic Oligonucleotide 62accatggacg agctgtttcc cctc 24 63 24 DNA Artificial Sequence SyntheticOligonucleotide 63 accatggacg acctgtttcc cctc 24 64 24 DNA ArtificialSequence Synthetic Oligonucleotide 64 accatggacg tactgtttcc cctc 24 6524 DNA Artificial Sequence Synthetic Oligonucleotide 65 accatggacggtctgtttcc cctc 24 66 24 DNA Artificial Sequence SyntheticOligonucleotide 66 accatggacg ttctgtttcc cctc 24 67 15 DNA ArtificialSequence Synthetic Oligonucleotide 67 cacgttgagg ggcat 15 68 15 DNAArtificial Sequence Synthetic Oligonucleotide 68 ctgctgagac tggag 15 6912 DNA Artificial Sequence Synthetic Oligonucleotide 69 tcagcgtgcg cc 1270 17 DNA Artificial Sequence Synthetic Oligonucleotide 70 atgacgttcctgacgtt 17 71 17 DNA Artificial Sequence Synthetic Oligonucleotide 71tctcccagcg ggcgcat 17 72 18 DNA Artificial Sequence SyntheticOligonucleotide 72 tctcccagcg cgcgccat 18 73 20 DNA Artificial SequenceSynthetic Oligonucleotide 73 tccatgtcgt tcctgtcgtt 20 74 20 DNAArtificial Sequence Synthetic Oligonucleotide 74 tccatagcgt tcctagcgtt20 75 21 DNA Artificial Sequence Synthetic Oligonucleotide 75 tcgtcgctgtctccgcttct t 21 76 19 DNA Artificial Sequence Synthetic Oligonucleotide76 tcctgacgtt cctgacgtt 19 77 19 DNA Artificial Sequence SyntheticOligonucleotide 77 tcctgtcgtt cctgtcgtt 19 78 20 DNA Artificial SequenceSynthetic Oligonucleotide 78 tccatgtcgt ttttgtcgtt 20 79 20 DNAArtificial Sequence Synthetic Oligonucleotide 79 tccaggactt ctctcaggtt20 80 20 DNA Artificial Sequence Synthetic Oligonucleotide 80 tccatgcgtgcgtgcgtttt 20 81 20 DNA Artificial Sequence Synthetic Oligonucleotide 81tccatgcgtt gcgttgcgtt 20 82 20 DNA Artificial Sequence SyntheticOligonucleotide 82 tccacgacgt tttcgacgtt 20 83 20 DNA ArtificialSequence Synthetic Oligonucleotide 83 gcggcgggcg gcgcgcgccc 20 84 25 DNAArtificial Sequence Synthetic Oligonucleotide 84 tgtcgttgtc gttgtcgttgtcgtt 25 85 13 DNA Artificial Sequence Synthetic Oligonucleotide 85tgtcgttgtc gtt 13 86 20 DNA Artificial Sequence SyntheticOligonucleotide 86 tccacgacgt tttcgacgtt 20 87 20 DNA ArtificialSequence Synthetic Oligonucleotide 87 tccatgacga tcctgatgct 20 88 20 DNAArtificial Sequence Synthetic Oligonucleotide 88 tccatgacgc tcctgatgct20 89 15 DNA Artificial Sequence Synthetic Oligonucleotide 89 gctagacgttagcgt 15 90 8 DNA Artificial Sequence Synthetic Oligonucleotide 90tcaacgtt 8 91 8 DNA Artificial Sequence Synthetic Oligonucleotide 91tcaagctt 8 92 8 DNA Artificial Sequence Synthetic Oligonucleotide 92tcagcgct 8 93 8 DNA Artificial Sequence Synthetic Oligonucleotide 93tcatcgat 8 94 8 DNA Artificial Sequence Synthetic Oligonucleotide 94tcttcgaa 8 95 8 DNA Artificial Sequence Synthetic Oligonucleotide 95ccaacgtt 8 96 8 DNA Artificial Sequence Synthetic Oligonucleotide 96tcaacgtc 8 97 20 DNA Artificial Sequence Synthetic Oligonucleotide 97tccaggactt tcctcaggtt 20 98 20 DNA Artificial Sequence SyntheticOligonucleotide 98 ttcaggactt tcctcaggtt 20 99 20 DNA ArtificialSequence Synthetic Oligonucleotide 99 ggcgttattc ctgactcgcc 20 100 22DNA Artificial Sequence Synthetic Oligonucleotide 100 cctacgttgtatgcgcccag ct 22 101 7 DNA Artificial Sequence Synthetic Oligonucleotide101 tgtcgct 7 102 7 DNA Artificial Sequence Synthetic Oligonucleotide102 tgtcgtt 7 103 7 DNA Artificial Sequence Synthetic Oligonucleotide103 tgacgtc 7 104 8 DNA Artificial Sequence Synthetic Oligonucleotide104 tgacgtca 8 105 6 DNA Artificial Sequence Synthetic Oligonucleotide105 aacgtt 6 106 7 DNA Artificial Sequence Synthetic Oligonucleotide 106caacgtt 7 107 8 DNA Artificial Sequence Synthetic Oligonucleotide 107aacgttct 8 108 7 DNA Artificial Sequence Synthetic Oligonucleotide 108tgacgtt 7 109 6 DNA Artificial Sequence Synthetic Oligonucleotide 109gccggt 6 110 6 DNA Artificial Sequence Synthetic Oligonucleotide 110gacggt 6 111 6 DNA Artificial Sequence Synthetic Oligonucleotide 111gacgtc 6 112 6 DNA Artificial Sequence Synthetic Oligonucleotide 112cacgtg 6 113 7 DNA Artificial Sequence Synthetic Oligonucleotide 113cgacgtt 7 114 20 DNA Artificial Sequence Synthetic Oligonucleotide 114atggaaggtc cagtgttctc 20 115 20 DNA Artificial Sequence SyntheticOligonucleotide 115 atggactctc cagcgttctc 20 116 20 DNA ArtificialSequence Synthetic Oligonucleotide 116 atcgactctc gagngttctc 20 117 15DNA Artificial Sequence Synthetic Oligonucleotide 117 gctagangtt agtgt15 118 18 DNA Artificial Sequence Synthetic Oligonucleotide 118catttccacg atttccca 18 119 21 DNA Artificial Sequence SyntheticOligonucleotide 119 tcgtcgctgt ctgcccttct t 21 120 21 DNA ArtificialSequence Synthetic Oligonucleotide 120 tcgtcgctgt tgtcgtttct t 21 121 20DNA Artificial Sequence Synthetic Oligonucleotide 121 tccttgtcgttcctgtcgtt 20 122 20 DNA Artificial Sequence Synthetic Oligonucleotide122 tccatgtngt tcctgtngtt 20 123 23 DNA Artificial Sequence SyntheticOligonucleotide 123 tcgtcgtttt gtcgttttgt cgt 23

I claim:
 1. A method for increasing the responsiveness of a cancer cellto a cancer therapy using an immunostimulatory nucleic acid as comparedto the absence of the immunostimulatory nucleic acid, comprising:administering to a subject having a cancer an effective amount forincreasing the responsiveness of a cancer cell to a cancer therapy of animmunostimulatory nucleic acid, comprising: 5′X₁X₂CGX₃X₄3′  wherein C isunmethylated, wherein X₁X₂ and X₃X₄ are nucleotides, and wherein thesequence is not palindromic.
 2. The method of claim 1, furthercomprising administering a chemotherapeutic agent.
 3. The method ofclaim 1, further comprising administering a cancer immunotherapeuticagent.
 4. The method of claim 1, wherein the cancer is brain cancer. 5.The method of claim 1, wherein the cancer is lung cancer.
 6. The methodof claim 1, wherein the cancer is ovary cancer.
 7. The method of claim1, wherein the cancer is breast cancer.
 8. The method of claim 1,wherein the cancer is prostate cancer.
 9. The method of claim 1, whereinthe cancer is colon cancer.
 10. The method of claim 1, wherein thecancer is leukemia.
 11. The method of claim 1, wherein the cancer iscarcinoma.
 12. The method of claim 1, wherein the cancer is sarcoma. 13.The method of claim 1, wherein at least one nucleotide has a phosphatebackbone modification.
 14. The method of claim 13, wherein the phosphatebackbone modification is a phosphorothioate or phosphorodithioatemodification.
 15. The method of claim 14, wherein the nucleic acidbackbone includes the phosphate backbone modification on the 5′inter-nucleotide linkages.
 16. The method of claim 14, wherein thenucleic acid backbone includes the phosphate backbone modification onthe 3′ inter-nucleotide linkages.
 17. The method of claim 1, wherein theoligonucleotide has 8 to 100 nucleotides.
 18. The method of claim 1,wherein X₁X₂ are nucleotides selected from the group consisting of: GpT,GpG, GpA, ApA, ApT, ApG, CpT, CpA, CpG, TpA, TpT, and TpG; and X₃X₄ arenucleotides selected from the group consisting of: TpT, CpT, ApT, TpG,ApG, CpG, TpC, ApC, CpC, TpA, ApA, and CpA.
 19. The method of claim 1,wherein X₁X₂ are GpA and X₃X₄ are TpT.
 20. The method of claim 1,wherein X₁X₂ are both purines and X₃X₄ are both pyrimidines.
 21. Themethod of claim 1, wherein X₁X₂ are GpA and X₃X₄ are both pyrimidines.22. The method of claim 1, wherein the oligonucleotide is 8 to 40nucleotides in length.
 23. The method of claim 1, wherein theoligonucleotide is isolated.
 24. The method of claim 1, wherein theoligonucleotide is a synthetic oligonucleotide.
 25. A method forenhancing recovery of bone marrow using an immunostimulatory nucleicacid as compared to the absence of the immunostimulatory nucleic acid ina subject undergoing or having undergone cancer therapy, comprising:administering to a subject undergoing or having undergone cancer therapywhich damages the bone marrow an effective amount for enhancing therecovery of bone marrow of an immunostimulatory nucleic acid,comprising: 5′X₁X₂CGX₃X₄3′  wherein C is unmethylated, wherein X₁X₂ andX₃X₄ are nucleotides.
 26. The method of claim 25, wherein at least onenucleotide has a phosphate backbone modification.
 27. The method ofclaim 26, wherein the phosphate backbone modification is aphosphorothioate or phosphorodithioate modification.
 28. The method ofclaim 25, wherein the oligonucleotide has 8 to 100 nucleotides.
 29. Themethod of claim 25, wherein X₁X₂ are nucleotides selected from the groupconsisting of: GpT, GpG, GpA, ApA, ApT, ApG, CpT, CpA, CpG, TpA, TpT,and TpG; and X₃X₄ are nucleotides selected from the group consisting of:TpT, CpT, ApT, TpG, ApG, CpG, TpC, ApC, CpC, TpA, ApA, and CpA.
 30. In amethod for stimulating an immune response in a subject having a cancer,the method of the type involving antigen dependent cellular cytotoxicity(ADCC), the improvement comprising: administering to the subject animmunostimulatory nucleic acid, comprising: 5′X₁X₂CGX₃X₄3′  wherein C isunmethylated, wherein X₁X₂ and X₃X₄ are nucleotides.
 31. The method ofclaim 30, wherein at least one nucleotide has a phosphate backbonemodification.
 32. The method of claim 30, wherein the oligonucleotidehas 8 to 100 nucleotides.
 33. The method of claim 32, wherein thephosphate backbone modification is a phosphorothioate orphosphorodithioate modification.
 34. The method of claim 32, whereinX₁X₂ are nucleotides selected from the group consisting of: GpT, GpG,GpA, ApA, ApT, ApG, CpT, CpA, CpG, TpA, TpT, and TpG; and X₃X₄ arenucleotides selected from the group consisting of: TpT, CpT, ApT, TpG,ApG, CpG, TpC, ApC, CpC, TpA, ApA, and CpA.
 35. The method of claim 30,wherein 5′ X₁X₂CGX₃X₄ 3′ is not palindromic.
 36. A method for treatingor preventing cancer, comprising: administering to a subject having acancer an effective amount for treating or preventing cancer of animmunostimulatory nucleic acid, comprising: 5′X₁X₂CGX₃X₄3′  wherein C isunmethylated, wherein X₁X₂ and X₃X₄ are nucleotides, and wherein thesequence is not palindromic.
 37. The method of claim 36, furthercomprising administering a chemotherapeutic agent.
 38. The method ofclaim 36, further comprising administering a cancer immunotherapeuticagent.
 39. The method of claim 36, wherein the cancer is brain cancer.40. The method of claim 36, wherein the cancer is lung cancer.
 41. Themethod of claim 36, wherein the cancer is ovarian cancer.
 42. The methodof claim 36, wherein the cancer is breast cancer.
 43. The method ofclaim 36, wherein the cancer is prostate cancer.
 44. The method of claim36, wherein the cancer is colon cancer.
 45. The method of claim 36,wherein the cancer is leukemia.
 46. The method of claim 36, wherein thecancer is carcinoma.
 47. The method of claim 36, wherein the cancer issarcoma.
 48. The method of claim 36, wherein at least one nucleotide hasa phosphate backbone modification.
 49. The method of claim 48, whereinthe phosphate backbone modification is a phosphorothioate orphosphorodithioate modification.
 50. The method of claim 49, wherein thenucleic acid backbone includes the phosphate backbone modification onthe 5′ inter-nucleotide linkages.
 51. The method of claim 49, whereinthe nucleic acid backbone includes the phosphate backbone modificationon the 3′ inter-nucleotide linkages.
 52. The method of claim 36, whereinthe oligonucleotide has 8 to 100 nucleotides.
 53. The method of claim36, wherein X₁X₂ are nucleotides selected from the group consisting of:GpT, GpG, GpA, ApA, ApT, ApG, CpT, CpA, CpG, TpA, TpT, and TpG; and X₃X₄are nucleotides selected from the group consisting of: TpT, CpT, ApT,TpG, ApG, CpG, TpC, ApC, CpC, TpA, ApA, and CpA.
 54. The method of claim36, wherein X₁X₂ are GpA and X₃X₄ are TpT.
 55. The method of claim 36,wherein X₁X₂ are both purines and X₃X₄ are both pyrimidines.
 56. Themethod of claim 36, wherein X₁X₂ are GpA and X₃X₄ are both pyrimidines.57. The method of claim 36, wherein the oligonucleotide is 8 to 40nucleotides in length.